Tactical Combat Casualty Care and Wound Treatment by Department of Defense

Author:Department of Defense
Format: epub
Publisher: Perseus Books, LLC
Published: 2015-03-10T16:00:00+00:00

Figure 3-11. Tension pneumothorax resulting from a closed chest injury.

b. Hemothorax. Hemothorax is a condition in which blood enters the pleural cavity outside the lung and becomes trapped. As more and more blood becomes trapped, the increased pressure causes the lung in the affected pleural cavity to collapse (figure 3-12). Hemothorax can be caused by any chest injury. It can result from lacerated blood vessels in the chest wall, lacerated major blood vessels within the chest, or laceration of the lung. Signs and symptoms of tension pneumothorax also apply to hemothorax. In addition, hemothorax may result in hypovolemic shock. Tension pneumothorax and hemothorax may be present together. A hemothorax is more likely to cause significant hypovolemia before tension could be built up. The left and right lung spaces and the mediastinum can hold more than three liters of fluid (over half of the circulating blood volume).

NOTE: Figures 3-11 and 3-12 do not show a significant trachea deviation or mediastinal shift. As the pressure increases and the injured (right) lung collapses, the trachea and heart will be pushed more and more toward the casualty’s uninjured (left) side. The shift will compress the heart and the uninjured (left) lung.

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