[Primary management of patients with chest injuries at the scene of the accident].

The role of emergency medicine concerning the management of thoracic trauma patients at the site of accident is described, as well as the underlying causes of the development of the mediastinal shock as there are chest wall instability, tension pneumothorax, cardiac tamponade and cardiac contusion. Diagnosis and emergency treatment of these acute situations and the technique of safe chest tube placement are described. The role of volume support, artificial respiration and suction drainage of the chest at the site of accident are emphasized.