[Thoracic trauma in the pre-hospital phase]

Preclinically relevant injuries of the thorax are described patho-physiologically. The diagnosis at the scene of accident and the treatment of the emergency of the functional after-effect injury are described. Respiratory insufficiency requires early artificial respiration. A pneumothorax should be drained, at least, on the respired patient. If there is a pneumothorax associated with tension due to the confined air, the relief would be obligatory. The relief should take place after the digital opening of the thorax by silicon drainage. If there is a mediastinal emphysema with a seriously haemodynamic effect, the relief would be indicated by collar mediastinostomy. If there is a pericardium tamponade with circulatory collapse after a perforating trauma, the patient must be brought to the medical attention of a surgeon as quickly as possible. The delay in time must not be the consequence of the relief of puncture. If a person injured in an accident who has a rupture of the trachea can not be respired immediate exposure of the rupture site is imperative. Resuscitation measures in case of an injured thorax must be done at the opened thorax.