[Stress tolerance following traumas of the thorax and great vessels]

After clinical investigation the most important diagnostic procedure is the simple chest X-ray in upright position. In case of hemothorax or pneumothorax the insertion of a large chest tube in the third of fourth intercostal space is necessary. Patients with traumatic flail chest and paradoxical respiration need first of all immediate intubation and artificial respiration, afterwards operative stabilization is beneficial in selected patients. In case of severe intrathoracic hemorrhage and in case of injuries of the lungs, heart and great vessels an active surgical approach is a life-saving treatment. Apart from patients with very bad general condition the usual diagnostic measures and an adequate conservative or surgical treatment can always be tolerated by the patient considering his life threatening condition.