Treatment

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