Consider the following:

  • Insert a nasogastric tube gently to drain stomach content. The insertion of the chest drain is to drain any associated pneumo/haemothoraces.
  • A cautiously placed chest drain using the traditional open technique, not Seldinger, is indicated
  • Surgical repair needs to be considered in the context of associated injuries
  • Examine the CT carefully in patients who have sustained a (blunt) abrupt increase in intra-abdominal pressure
  • Diaphragmatic injury needs excluding by your surgical colleagues in cases of penetrating injury requiring theatre.