-Haemothorax is a collection of blood in the pleural space and may be caused by blunt or penetrating trauma.
–Most haemothoraces are the result of rib fractures, lung parenchymal and minor venous injuries, and as such are self-limiting.
–Less commonly there is an arterial injury, which is more likely to require surgical repair.
–Most small-moderate haemothoraces are not detectable by physical examination and will be identified only on Chest X-ray, FAST,or CT scan.
–Large hemothoraces that are clinically detectable must be treated promptly.
- –Massive hemoptysis may require isolation
- of the affected lung with DLT or endobronchial blocker tube. (This will also allow for ventilation of unaffected side.)
–If separation is not possible or even moderate airway pressures will cause considerable bronchial leaking, jet ventilation is used.
- (air leakage from traumatized bronchi can track an open pulmonary vein causing
- pulmonary and systemic air embolism. Need to fix the leak!