ICU · Trauma

Chest Trauma — Blunt, Penetrating, Flail Chest & Cardiac Tamponade

Also known as Chest trauma · Flail chest · Pulmonary contusion · Cardiac tamponade · Beck triad · Tension pneumothorax · Massive haemothorax · Traumatic aortic injury · Traumatic diaphragmatic injury · Resuscitative thoracotomy

The chest trauma in the ICU: the blunt (the flail chest — the paradoxical movement; the pulmonary contusion; the cardiac tamponade — the Beck triad; the traumatic aortic injury; the diaphragmatic rupture) and the penetrating (the pneumothorax, the haemothorax, the great vessel, the cardiac). The immediately life-threatening (the ATLS): the tension pneumothorax, the massive haemothorax, the flail chest, the open pneumothorax, the cardiac tamponade. The management: the chest drain (the pneumothorax and the haemothorax), the surgical exploration (the massive haemothorax over 1500 mL initially or over 200 mL per hour for 3 hours with refractory shock (de Lesquen Grade D), the cardiac tamponade, the great vessel), the resuscitative thoracotomy (the arrest post-penetrating). The flail chest — the analgesia (the epidural preferred), the ventilation (the CPAP trial or the invasive for the respiratory failure), the pulmonary contusion — the resuscitation to adequate perfusion without excessive restriction, the lung-protective support.

Checked against its sources on 3 Sept 2026