Chest trauma: First 48hours management.

Area of Science:

• Trauma Surgery
• Emergency Medicine
• Critical Care Medicine

Background:

• Chest trauma, regardless of severity, poses significant challenges to healthcare systems.
• Severe chest trauma contributes to 25% of mortality in multiple trauma cases.
• Mild chest trauma can lead to considerable morbidity, particularly in patients with pre-existing conditions.

Purpose of the Study:

• To establish evidence-based guidelines for the management of chest trauma.
• To provide recommendations for both prehospital and in-hospital settings within the initial 48 hours.
• To address key aspects including severity assessment, diagnosis, ventilatory support, analgesia, chest tube placement, and surgical repair.

Main Methods:

• A systematic GRADE approach was employed to rate evidence across studies.
• Expert recommendations were developed by the "Société française d'anesthésie réanimation" and the "Société française de médecine d'urgence".
• The Delphi method was used for expert consensus on 60 defined recommendations.

Main Results:

• Sixty recommendations were established covering critical aspects of chest trauma care.
• Guidelines address severity criteria, diagnostic strategies, ventilatory support, and pain management.
• Specific recommendations are provided for chest tube placement and surgical/endovascular repair indications.

Conclusions:

• The developed guidelines provide a crucial framework for managing chest trauma patients.
• These recommendations aim to optimize patient outcomes by standardizing care in emergency settings.
• The guidelines offer a much-needed resource in the absence of existing recommendations from scientific societies.