RT Book, Section
A1 Reichman, Eric F.
A2 Reichman, Eric F.
SR Print(0)
ID 1159797561
T1 Hilum and Great Vessel Wound Management
T2 Reichman's Emergency Medicine Procedures, 3e
YR 2018
FD 2018
PB McGraw-Hill Education
PP New York, NY
SN 9781259861925
LK accessemergencymedicine.mhmedical.com/content.aspx?aid=1159797561
RD 2024/04/19
AB Injuries  to  the  thoracic  great  vessels  can  be  a  significant  cause  of  morbidity  and  mortality.  Large  vessels  in  the  hilum  of  the  lung  include  the  pulmonary  artery  and  vein.  The  great  vessels  also  include  the  vena  cava,  aorta,  innominate  artery,  subclavian  artery,  and  subclavian  vein.  The  mortality  from  injuries  to  the  subclavian  artery  is  approximately  5%  if  patients  who  are  moribund  on  admission  to  the  Emergency  Department  are  excluded.1  However,  the  mortality  from  injury  to  the  vena  cava  and  the  pulmonary  vessels  is  over  60%.2  While  over  85%  of  patients  with  penetrating  injuries  to  the  thorax  are  stable,  the  remainder  present  in  varying  levels  of  hypovolemic  shock.  They  may  have  bled  externally  or  into  the  chest.  Each  hemithorax  can  hold  up  to  one-half  of  an  individual’s  blood  volume.  In  these  cases,  an  Emergency  Department  thoracotomy  may  be  performed  for  hypovolemic  shock.