PENETRATING CHEST INJURIES

UNSTABLE

CHEST TUBE PLACEMENT

ENDOTRACHEAL INTUBATION I.V. FLUIDS
(UNI or BILATERAL)

REASSESSMENT

STABLE CHEST TUBE SIGNS

WOUND OUTPUT OF
IN THE BOX PERICARDIAL TAMPONADE

CHEST X-RAY
STABLE? > 1200cc
or
> 200cc/hr
ECHO TRANSMEDIASTINAL TO OPERATING ROOM
AND/OR Yes TRAJECTORY FOR
PERICARDIAL PERICARDIAL WINDOW /
WINDOW THORACOTOMY (L) THORACOTOMY
(open the side of the
CHEST CT WITH hemothorax first)
CONTRAST

EMERGENCY CONSIDER:
No
THORACOTOMY BRONCHOSCOPY
(Start on the (L) side) Inferior Superior ESOPHAGOSCOPY/
ESOPHOGRAM
R/O CARDIAC INJURY MEDIASTINUM
ANGIOGRAPHY
CHEST CT AORTIC
ECHO / PERICARDIAL PROTOCOL
WINDOW Inferior

R/O ESOPHAGEAL ESOPHAGOSCOPY/

INJURY ESOPHAGOGRAM
Revised 6/2/04
© 2001