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Management of adults with blunt chest trauma in the emergency department

Management of adults with blunt chest trauma in the emergency department

ED: emergency department; E-FAST: extended focused assessment with sonography in trauma; ECG: electrocardiogram; AP: anteroposterior; CXR: chest radiograph; PTX: pneumothorax; CT: computed tomography; IV: intravenous; TEE: transesophageal echocardiography; PA: posterior-anterior; BAI: blunt aortic injury; US: ultrasound.

* This algorithm is a general guide; sophisticated imaging may not be necessary in all circumstances.

¶ For example, high-risk mechanisms of injury include (but are not limited to) MVCs with no seatbelt use, extensive vehicular damage, steering wheel deformity, or speed >40 miles per hour (>65 kilometers per hour); fall >20 feet (>6 meters); anything that causes rapid deceleration.

Δ Secondary survey is a history and head-to-toe physical exam.

◊ For CXR findings concerning for BAI, refer to UpToDate content on blunt thoracic trauma or diagnostic algorithm for blunt aortic injury in adults.
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