Emergency War Surgery NATO Handbook: Part IV: Regional Wounds and Injuries: Chapter XXVIII: Wounds and Injuries of the Chest
United States Department of Defense
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Whatever could have been done at the unit level but was not done should be done by the divisional medical officer. Chest tubes should be connected to underwater seal and suction. X-ray will help determine whether additional tubes are needed. Antibiotic administration should be continued. The ability to infuse blood may make possible the salvage of occasional casualties who are exsanguinating. Perhaps the most important function of this echelon of care is triage. Two categories of casualties need to be recognized: those who need early surgical care and therefore need priority evacuation, and those casualties who stand a good chance of early return to duty. Thoracic casualties with little or no air leak or bleeding are good candidates for prompt return to duty and should be removed from the evacuation pathway.
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