Team management of the chest trauma patient

Abstract

1934, Alfred Blalock, a pioneer in the field of cardiac surgery, was the first American surgeon to successfully repair an aortic injury. Thoracic trauma was still in its infancy when treatment guidelines were established during World War II.1 In 1957, Klassen became the first surgeon to successfully repair a traumatic blunt aortic injury (BAI).2 Until that time, prominent medical journals advised surgeons to avoid blunt chest trauma surgery. Since then, however, advances in trauma and cardiac surgery, surgical intensive care unit (SICU) resuscitation, critical care, and perioperative nursing have improved the care and recovery of the chest trauma patient.2 Statistics Trauma is the leading cause of all deaths, morbidity, hospitalizations, and disability from the first year of life through middle age, and results in over 100,000 deaths annually.3 According to the 2006 National Trauma Data Bank report (NTDB), motor vehicle collisions (MVC) accounted for 41.3% of all injured patients, falls comprised 27.2%, and firearm injuries caused 5.6% of trauma injuries between 2001 and 2005.4 Chest trauma accounts for 25% to 50% of all traumatic injuries and is a leading cause of death in all age groups; MVCs account for 70% to 80% of all chest trauma injuries. Aortic injury is the second most common cause of death in blunt trauma patients,2 and an estimated 8,000 deaths per year are caused by BAI.5 chest trauma patient Team management of the