TY - CHAP M1 - Book, Section TI - Trauma Thoracotomy: Principles and Techniques A1 - Ghanta, Ravi K. A1 - Wall Jr, Matthew J. A1 - Mattox, Kenneth L. A2 - Feliciano, David V. A2 - Mattox, Kenneth L. A2 - Moore, Ernest E. PY - 2020 T2 - Trauma, 9e AB - KEY POINTSDespite frequent emphasis on devastating injuries, the most common thoracic injury is a chest wall contusion or rib fracture.History, physical examination, and chest x-ray remain fundamental to the diagnosis of thoracic injury. Additional imaging, including extended focused ultrasonography assessment for trauma, computed tomography (CT) scanning, and CT angiography are frequently used.A thoracostomy tube output of 1500 mL of blood on insertion or 200 mL of blood per hour usually warrants an urgent thoracotomy.A left anterolateral thoracotomy through the third or fourth interspace allows exposure for opening the pericardium, open cardiac massage, clamping of the descending thoracic aorta, and treatment of a large percentage of cardiac and left lung injuries.A retained hemothorax should be evacuated by video-assisted thoracoscopy or thoracotomy as soon as diagnosed.New technologies, such as retrograde endovascular balloon occlusion of the aorta and extracorporeal cardiopulmonary resuscitation, have the potential to further change the philosophy of prehospital management for thoracic injuries. SN - PB - McGraw Hill CY - New York, NY Y2 - 2024/04/19 UR - accesssurgery.mhmedical.com/content.aspx?aid=1175133552 ER -