Prehospital care of the patient with an injured chest.

The trauma patient with thoracic injury poses special problems for the paramedic. A chest injury frequently is a signal of other injury and alerts the paramedic to transport the patient to the regional trauma center, regardless of triage criteria applicable in any general area. In patients with chest injury, fluids should be judiciously administered, and pneumatic garments should NOT be applied. Trocar chest tubes should be avoided. Airway management is of prime importance, and the airway can be assured and protected by the paramedics. As time is of prime concern, the patient with thoracic injury should be transported as soon as possible to a regional trauma center. For distances of less than 35 miles, advanced life-support ground ambulances are preferable to air ambulances.