What is the primary concern in the initial evaluation of pneumothorax following a trauma?

Updated: Apr 28, 2020
  • Author: Brian J Daley, MD, MBA, FACS, FCCP, CNSC; Chief Editor: Mary C Mancini, MD, PhD, MMM  more...
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Answer

In the evaluation of trauma patients, airway and breathing collectively are the primary concern. Portable chest radiography is veritably always included in the initial radiographic evaluation of a major trauma victim, as significant chest injuries may be masked by lack of physical findings or associated injuries. Chest trauma carries an estimated 10-50% risk of associated pneumothorax.

Computed tomography (CT) of the chest likewise should always be performed for significant chest injuries, because plain radiographs may miss associated thoracic trauma. Specifically for pneumothorax, the presence of a pneumothorax seen only on CT defines it as occult. In stable patients, however, chest radiography is often unnecessary. [35, 36]


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