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Initial evaluation and stabilization of children with thoracic trauma

Donna Reyes Mendez, MD
Section Editor
Richard G Bachur, MD
Deputy Editor
James F Wiley, II, MD, MPH


The initial evaluation and stabilization of children with thoracic trauma will be reviewed here. Thoracic trauma in adults and specific thoracic injuries in children are discussed separately. (See "Initial evaluation and management of blunt thoracic trauma in adults" and "Overview of intrathoracic injuries in children" and "Chest wall injuries in children" and "Pulmonary contusion in children".)


Among injured children, thoracic trauma occurs infrequently. In several observational series describing pediatric trauma victims, between 4 and 8 percent of children sustained thoracic injury [1-4].

Blunt mechanisms are involved in 85 percent or more of cases [1-4]. Most patients are injured as passengers or pedestrians in motor vehicle crashes. Other mechanisms include falls (8 to 10 percent) and abuse (7 to 8 percent). Children with inflicted injuries usually have rib fractures and are young (typically less than three years of age) [5,6]. (See "Orthopedic aspects of child abuse", section on 'Rib fractures'.)

Penetrating thoracic trauma may be caused by a gunshot wound or from stabbing/impalement:

In the United States, gunshot wounds are the major cause of penetrating thoracic injury among children. A retrospective study describing reports to the National Pediatric Trauma Registry noted that 60 percent of penetrating thoracic injuries were the result of gunshot wounds, while 33 percent were from stab wounds [3].


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Literature review current through: Sep 2016. | This topic last updated: Sep 28, 2015.
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