Zusammenfassung
Das Thoraxtrauma ist ein komplexes Verletzungsmuster, dessen Diagnostik und Therapie
einem Notfallteam alles abverlangen. Der Begriff beschreibt Verletzungen des Brustkorbs
in allen Facetten – von der Prellmarke eines Sicherheitsgurtes bis zum tödlichen Überrolltrauma
mit Quetschung oder Zerreißung der Thoraxorgane. Bei der Therapie können sonografische
Diagnostik und invasive Notfalltechniken erforderlich werden, die dieser Beitrag darstellt.
Abstract
Chest Trauma is a complex injury pattern whose diagnostics and therapy demand everything
from an emergency response team. Chest trauma subsumes thoracic injuries in all facets
from the bounce mark of a seat belt to fatal rollover trauma with contusion or disruption
of organs located in the thorax. Possible causes comprise blunt or penetrating trauma,
as well as decelerations, chemical and thermal damage. Sonographic assessment according
to a protocol plays a major role in diagnosis of underlying conditions and treatment
indications. Therapeutic management may include invasive emergency techniques: Decompression
of a tension pneumothorax is a fundamental life-saving intervention. Pericardiocentesis
seldomly is necessary or possible in order to drain a cardiac tamponade. In case of
traumatic cardiac arrest and under defined circumstances, resuscitative thoracotomy
may be indicated. The out-of-hospital management may require transfusion of blood
components. As with all
procedures, which are performed seldomly but under emergency conditions, invasive
techniques require clear communication, precise structured working procedures and
especially continuous training, team briefing, and debriefing.
Schlüsselwörter
Thoraxtrauma - invasive Notfalltechniken - Notfallmedizin - Sonografie
Key words
thoracic injuries - invasive emergency procedures - emergency medicine - ultrasonography
