Each role of care has unique approaches to the management of thoracic trauma:

  • Role 1: The focus is treatment or stabilization of immediate life-threatening thoracic injuries, such as airway obstruction, and tension pneumothorax. Follow the Tactical Combat Casualty Care guidelines for treatment of chest trauma.5
  • Role 2: Care is focused on resuscitation and damage control surgical procedures. Tube thoracostomy placement is a critical diagnostic and therapeutic intervention. Anterolateral thoracotomy or sternotomy may be required for acutely bleeding patients.
  • Role 3: Definitive surgical treatment should be attempted for most injuries, with the possible exception of complex tracheobronchial or great vessel injuries.
  • Role 4: Definitive therapy.