Key Points

• Thoracic trauma typically affects the young. It is the leading cause of death in the first three decades of life, and its incidence is increasing.
• Life-threatening injuries need to be identified and treated immediately, remembering that injuries may develop over time, become life threatening, and require reassessment if the patient’s condition deteriorates.
• Immediate deaths are usually due to massive hemorrhage from the heart or great vessels, and the earliest deaths are secondary to cardiac tamponade, airway obstruction, and aspiration with severe associated injuries.
• Optimal treatment requires a thorough knowledge of the etiology of the trauma, and the pathophysiology of the thorax and expertise in therapeutic interventions.