[Emergency treatment in chest trauma (author's transl)].

The measures taken by the emergency physician can in many cases decisively affect the subsequent course of a chest trauma. In cases where the injured person has to be extricated from collapsed structures the medical officer has to decide on the mode and sequence of the rescue operation, prevent further damage and initiate shock therapy, intubation and artificial ventilation while the rescue operation is in progress. Emergency treatment also includes infusion therapy, if necessary via a central venous catheter; intubation, suction drainage and artificial ventilation; evacuation of fluid from the pleural cavity, mediastinum and pericardium combined with electrodiagnosis (ECG) and electrotherapy (defibrillation) if necessary. By closely observing the reaction and condition of the patient during transport to hospital he can provide important information regarding further treatment, especially in polytraumatized persons. Close collaboration between the trained rescue teams of the Fire Service, the emergency medical officer and the hospital staff has succeeded in reducing the mortality rate of combined chest injuries to 13%. 87% of cases who had received emergency treatment were subsequently admitted to hospital.