Thoracic Trauma: Current Approach in Emergency Medicine

Author:

Caputo Giorgia1ORCID,Meda Stefano2,Piccioni Andrea3ORCID,Saviano Angela3ORCID,Ojetti Veronica4ORCID,Savioli Gabriele5ORCID,Piccini Gaia Bavestrello6ORCID,Ferrari Chiara7,Voza Antonio89ORCID,Pellegrini Lavinia10,Ottaviani Miriam10,Spadazzi Federica10ORCID,Volonnino Gianpietro10ORCID,La Russa Raffaele11ORCID

Affiliation:

1. Division of Anesthesia and Critical Care, Santi Antonio e Biagio e Cesare Arrigo Hospital, 15121 Alessandria, Italy

2. Division of Thoracic Surgery, Santi Antonio e Biagio e Cesare Arrigo Hospital, 15121 Alessandria, Italy

3. Department of Emergency Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy

4. Internal Medicine Department, San Carlo di Nancy Hospital, 00165 Rome, Italy

5. Emergency Medicine and Surgery, IRCCS Fondazione Policlinico San Matteo, 27100 Pavia, Italy

6. Emergency Medicine Residency Program, Université Libre de Bruxelles, 1050 Brussels, Belgium

7. Division of Anesthesia, Intensive Care, Pain Medicine, Policlinico Hospital, 70124 Bari, Italy

8. Emergency Medicine, IRCCS Humanitas Research Hospital, Rozzano, 20089 Milan, Italy

9. Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20072 Milan, Italy

10. Department of Anatomical, Histological, Forensic and Orthopaedic Sciences, Sapienza University of Rome, Viale Regina Elena 336, 00161 Rome, Italy

11. Department of Clinical Medicine, Public Health, Life Sciences, Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy

Abstract

Chest trauma is the leading cause of death in people under 40. It is estimated to cause around 140,000 deaths each year. The key aims are to reduce mortality and the impact of associated complications to expedite recovery and to restore patient’s conditions. The recognition of lesions through appropriate imaging and early treatment already in the emergency department are fundamental. The majority can be managed in a non-surgical way, but especially after traumatic cardiac arrest, a surgical approach is required. One of the most important surgical procedures is the Emergency Department Thoracotomy (EDT). The aim of this review is to provide a comprehensive synthesis about the management of thoracic trauma, the surgical procedures, accepted indications, and technical details adopted during the most important surgical procedures for different thoracic trauma injuries. Literature from 1990 to 2023 was retrieved from multiple databases and reviewed. It is also important to emphasize the medico-legal implications of this type of trauma, both from the point of view of collaboration with the judicial authority and in the prevention of any litigation.

Publisher

MDPI AG

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