Key messages

• Most patients with chest injuries are treated non-operatively, with only 10 to 15 per cent requiring surgery.

• Initial therapy includes ensuring an adequate airway and ventilation, controlling sites of bleeding, and restoring adequate tissue perfusion.

• Closed-tube thoracostomy is the primary therapy for most patients with pneumothorax or hemothorax as a result of either penetrating or blunt trauma.

• Injuries to the heart and the aorta should be suspected in patients who have suffered significant blunt injuries to the thorax, particularly those due to deceleration forces.

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