Blunt thoracic trauma in the Emergency Department

Chest trauma is a common occurrence in patients with polytrauma admitted to the Emergency Department. Many scores and markers of high-dynamic impact help the physician to identify patients at risk for life-threatening conditions that must be promptly identified and treated during the primary evaluation. Often these patients may need tracheal intubation, oxygenation and/or ventilation, chest tube insertion, as well as fluids administration or blood transfusion. As chest trauma mat cause hypoxia and hypercapnia and acidosis due to inadequate ventilation, the overriding goal in treating chest trauma is to prevent or correct hypoxia, through ventilatory support and analgesic therapy. In this narrative review we aim at recalling the most recent indication for clinical approach, patient monitoring, and stratification, as well as the characteristics of the most insidious lesions that the emergency physician should bear in mind while approaching chest trauma patients.