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