Management of Chest Trauma Caused by Gunshot Wounds and Lessons Learned

Chest injuries account for nearly a quarter of all deaths from trauma - after head and neck injuries. Although rapid and immediate interventions at the scene of the accident are generally necessary, the importance of time at the scene of the accident should always be considered as one of the priorities in transferring the injured to higher hospital levels. Generally, pre-hospital management and transfer in the case of war victims may be somewhat different from urban injuries, because the type and severity of injuries are different and significant.

Case Report: 

A 34-year-old combatant was shot following his activities in the war zone and was taken to the field hospital within half an hour after the injury. He had been shot in the left side of the body, which penetrated the right side of the chest. At the time of his visit, the victim was conscious and speaking, complaining of abdominal pain and shortness of breath.

Since many cases of pneumothorax have a traumatic origin, special attention is needed in the diagnosis of simple or tension pneumothorax; especially in the manner of chest injuries. This may be done in an urban trauma with a more regular assessment than in combat situations. However, bullet-induced chest trauma is much more difficult and therefore more important in a crowded, stressful, and life-threatening condition on the battlefield.

Damage prevention is always considered the first step. The use of personal protection equipment (PPE) such as bulletproof vests could be somewhat preventive. In case of chest injuries, special chest wound dressing adhesives and especially asherman chest seals could be useful.