APPROACH TO THE PATIENT WITH THORACIC TRAUMA: INITIAL ASSESSMENT, CLINICAL MANAGEMENT, AND THERAPEUTIC STRATEGIES

Abstract

Introduction: Thoracic trauma is a significant cause of morbidity and mortality in patients who have experienced traffic accidents, falls, assaults, or other mechanisms of injury. Its manifestations range from minor chest wall injuries to life-threatening conditions, such as tension pneumothorax, massive hemothorax, cardiac tamponade, and injuries to major blood vessels. Early identification of these conditions and the timely implementation of therapeutic interventions are crucial for reducing complications and mortality. Objective: To describe the clinical approach to patients with thoracic trauma, emphasizing the initial assessment, key pathophysiological mechanisms, diagnostic methods, emergency interventions, and criteria for definitive treatment. Methodology: This is a narrative literature review based on trauma care guidelines, recommendations from medical societies, and scientific publications concerning the assessment and management of such injuries. Discussion: The initial approach should follow the principles of systematic trauma care, prioritizing the identification and immediate treatment of life-threatening conditions. The assessment includes evaluating the airway, ventilation, circulation, neurological status, and patient exposure. Physical examination, combined with bedside ultrasound, chest radiography, and computed tomography—depending on the patient's hemodynamic stability—guides the identification of injuries. Treatment may involve ventilatory support, chest drainage, hemostatic resuscitation, surgical hemorrhage control, and other specialized interventions. Conclusion: Managing thoracic trauma requires a systematic assessment, early recognition of life-threatening injuries, and therapeutic decisions based on clinical severity and hemodynamic stability. Integration between pre-hospital care, emergency services, trauma surgery, and intensive care is essential for improving clinical outcomes.