Imaging in Thoracic Trauma

Thoracic trauma is one of the commonest injury locations (after head and extremities) and has an overall mortality rate of 10%. The first step in thoracic trauma is to identify life-threatening conditions. Whilst clinical signs are cornerstone to identification, in many cases they generally necessitate further diagnostic testing. 3

NICE Guidelines state in the context of major trauma4

  • Imaging for chest trauma in patients with suspected chest trauma should be performed urgently, and the images should be interpreted immediately by a healthcare professional with training and skills in this area.
  • We should only consider immediate chest X-ray and/or eFAST (extended focused assessment with sonography for trauma) as part of the primary survey to assess chest trauma in adults (16 or over) with severe respiratory compromise.
  • In those without severe respiratory compromise who are responding to resuscitation or whose haemodynamic status is normal we should consider immediate CT for adults (16 or over). A whole-body CT should be used to investigate those with blunt major trauma and suspected multiple injuries.