Consider the following:

  • IPPV and positive end-expiratory pressure (PEEP) for the sicker patients
  • Judicious use of fluids – consider insertion of a central line and arterial line
  • No evidence for steroids or prophylactic antibiotics
  • Avoid colloids since these will breach injured lung tissue and worsen hypoxia
  • Discuss disposal of each patient with ITU and thoracic surgical colleagues
  • Lung contusion is a marker of significant injury
  • Early CXR evidence of contusion is particularly worrying
  • Oxygen therapy to keep saturations within target range