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April 1967

Thoracic Emergencies: Indications for Closed Tube Drainage and Early Open Thoracotomy

Author Affiliations

From the departments of surgery, University of Chicago Medical School, and Northwestern University Medical School, Chicago and Evanston Hospital, Evanston.

Arch Surg. 1967;94(4):532-538. doi:10.1001/archsurg.1967.01330100096015

THE PROPER treatment of thoracic emergencies requires prompt and accurate diagnosis and well-supervised care. The early restoration of normal cardiopulmonary relationships and functions is the key to successful management of these cases. Needle aspiration, closed tube drainage, and the place for open thoracotomy are important decisions in the care of these patients. A progressive increase in the number of emergency chest cases seen at the University of Chicago Hospitals prompted a review of our recent case material and results. Civil disturbances and violence caused a large proportion of our cases.

Case Material  All thoracic emergencies seen in the emergency room of the University of Chicago Hospitals from 1960 through 1965 were reviewed. Excluded from this report were minor soft tissue injuries, such as bruises and superficial lacerations (Table 1). There were 238 patients ranging in age from 6 to 76 years with an average of 37.5 years. Males made up