NON-LIFE-THREATENING BLUNT CHEST TRAUMA - APPROPRIATE INVESTIGATION AND TREATMENT

Non-life-threatening blunt chest trauma is a commonly occurring phenom enon. No clear guidelines exist in the literature regarding the approp riate investigation and treatment, and most clinicians' practice patte rns are based on anecdote, individual experience, and the theoretical risk of complications. A prospective study was undertaken of all patie nts with non-life threatening blunt chest trauma presenting to a high- volume, community-based teaching hospital emergency department. No cli nical features were found to have a high enough positive predictive Va lue for rib fracture or any other injury to warrant their use as a scr eening tool for further investigations. No significant lung injury was detected in the study cohort of patients, on either an immediate or d elayed basis. In the absence of compelling evidence of an underlying l ung injury, the performance of chest or rib radiography is of no benef it, and considerable cost savings can potentially be realized. Copyrig ht (C) 1997 by W.B. Saunders Company.