Traumacast Management of Hemothorax
Jun 30, 2025
Dr. Chasen Croft, an associate professor of surgery and trauma medical director at the University of Florida, shares his expertise on managing hemothorax. He discusses diagnostic techniques like ultrasound and CT scans and the evolving use of smaller bore chest tubes. The conversation dives into management strategies, weighing operative intervention against observation, and highlights advancements in thoracic irrigation. Croft also explores the efficacy of innovative drainage methods and the future of less invasive approaches in trauma care.
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Hemothorax Diagnosis Modalities
- Hemothorax is blood in the chest from trauma, usually from intercostal vessels and rib fractures.
- Ultrasound, chest x-ray, and CT scan each have pros and cons in detecting hemothorax.
When to Drain Hemothorax
- Large hemothorax needs chest drainage, either by chest tube or surgery based on blood output.
- Small hemothorax in stable patients can be observed, with chest tube placed if it enlarges.
Early Thoracic Irrigation Protocol
- For chest tubes placed, irrigate the thoracic cavity early and repeatedly with 1-2 liters saline in 500 ml aliquots.
- Thoracic irrigation decreases retained hemothorax, empyema, and need for later surgery.