General principles of management of patients with chest injury

Abstract

Emergency medical care for chest injuries requires an integrated approach, including monitoring of vital
signs, rest, oxygen therapy and drainage of the pleural cavity. For patients with stable hemodynamics, the
use of videothoracoscopy makes it possible to adequately assess the nature and severity of intrapleural
injuries, effectively sanitize the pleural cavity with clotted hemothorax, and helps to reduce the risk of
developing ARDS compared with patients with open thoracotomy. However, the expansion of indications
for thoracoscopy of patients with unstable hemodynamic parameters, with a large volume of hemothorax,
with signs of damage to the trachea and large bronchi, may cause an unreasonable delay in the inevitable
and necessary thoracotomy, thereby reducing the likelihood of a positive outcome of surgical treatment.