Integrated Clinical Pathways for Chest Injury involving EMS, Nursing Practice, Radiologic Assessment, Laboratory and Microbiological Testing, Dental Support Roles, and Nutrition Management

Abstract

Background: Chest trauma is a frequent and high-risk presentation in emergency medical services (EMS), accounting for nearly a quarter of all trauma-related deaths. These injuries, resulting from blunt or penetrating mechanisms, can rapidly compromise ventilation, oxygenation, and circulation, making timely assessment and management critical for patient survival.

Aim: This article aims to outline the principles of prehospital evaluation and management for chest trauma, emphasizing the role of EMS in rapid recognition, stabilization, and expedited transport to definitive care. It seeks to synthesize the pathophysiology, clinical assessment, and specific interventions for life-threatening thoracic conditions within the constraints of the field environment.

Methods: The approach is based on a structured primary survey (Airway, Breathing, Circulation) aligned with Advanced Trauma Life Support (ATLS) principles. Methods include rapid clinical assessment, essential life-support interventions (e.g., oxygen administration, hemorrhage control), and specific invasive procedures like needle decompression for tension pneumothorax and occlusive dressing for open chest wounds.

Results: Effective prehospital care focuses on identifying critical conditions such as tension pneumothorax, flail chest, and massive hemothorax. Interventions are time-sensitive and aimed at bridging the patient to hospital-based definitive care. The "load and go" strategy, minimizing on-scene time, is consistently associated with improved outcomes.

Conclusion: The prognosis for chest trauma patients is significantly improved by efficient EMS systems that prioritize rapid assessment, immediate life-saving interventions, and coordinated transport to appropriate trauma centers.