Pediatric emergency medicine trisk 4062 4062
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CHAPTER 124 ■ THORACIC EMERGENCIES
JOY L. COLLINS, MERCEDES M. BLACKSTONE
INTRODUCTION
Thoracic emergencies in children often result in life-threatening alterations in
cardiorespiratory physiology. A rapid, yet organized, approach to the child with a
thoracic emergency is essential. The purpose of this chapter is to describe
nontraumatic surgical diseases of the thorax and guide the evaluating healthcare
provider in the diagnosis and treatment of these conditions. Congenital
abnormalities that are usually diagnosed at birth are not included. Thoracic
trauma is discussed in Chapter 115 .
This chapter reviews the pathophysiology and clinical manifestations of
thoracic emergencies, as well as the general principles of physical and laboratory
assessment. Subsequent sections cover specific entities within the following
categories: (i) airway obstruction, (ii) violations of the pleural space, (iii) intrinsic
pulmonary lesions, (iv) mediastinal tumors, (v) diaphragmatic defects, and (vi)
chest wall tumors.
GOALS OF EMERGENCY THERAPY
Children with thoracic emergencies present with a spectrum of processes and
severities. Because of the potential for thoracic emergencies to be serious and
even life threatening, a rapid but organized approach to the assessment and
treatment of these patients is crucial. Providers should rapidly address respiratory
and hemodynamic compromise, and identify those entities that require prompt
surgical consultation in the ED.
KEY POINTS
