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November 22, 1971

Chest Injuries: Physiologic Principles and Emergency Management

Author Affiliations

Cedars-Sinai Medical Center Los Angeles

JAMA. 1971;218(8):1307. doi:10.1001/jama.1971.03190210161045

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This lucid presentation of the pathophysiology, diagnosis, and treatment of chest injuries is entirely clinical in approach, by an author who has treated more than 5,000 chest-injured patients. While he provides a bibliography, he does not in the text refer to these papers. Instead, to stress an important principle, he draws on his experience or uses cases representing an error in management. For example, a patient died, expectorating and drowning in blood thought secondary to bullet wounds of the chest and head. At necroscopy, the nasopharynx was found to be the only bleeding source. Conclusion: "Simple postnasal packing would have averted death."

The reader is first exposed to several excellent color illustrations by Frank Netter. A clear, practical discussion of all pertinent basic sciences follows, aimed primarily at the medical student. Standard bedside procedures such as nasotracheal suction or intercostal drainage techniques are then explained. A lengthy section on problems