Thoracic injuries are present in 12 to 50% of civilian trauma patients.1 Over 90% of these civilian injuries are due to a blunt mechanism, and less than 10% require surgical intervention.2 In contrast, significant thoracic trauma is present in only 10% of combat-injured patients, but the great majority of cases are associated with penetrating mechanism.3,4 The most common thoracic injuries are pneumothorax, pulmonary contusion, and chest wall trauma, whereas injuries to the lung or great vessels have the highest mortality rate.3 Tube thoracostomy is indicated as an initial diagnostic and therapeutic intervention for the majority of patients with thoracic trauma. For more severe injuries, thoracotomy (primarily anterolateral), sternotomy, or other surgical approach may be indicated on an emergency basis.