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Trauma to the thorax is often categorized as penetrating (i.e., gunshot wound, stab wound) or blunt (i.e., motor vehicle collision, fall). Bedside ultrasound is useful in the initial assessment of the patient with chest trauma to rapidly evaluate for pneumothorax and pericardial effusion as part of the extended focused assessment with sonography in trauma (eFAST).
Penetrating injuries to “the box” (the area defined by the clavicles superiorly, nipple lines laterally, and costal margins inferiorly) are of particular concern because of the high likelihood of injury to the heart and mediastinal structures. The diaphragm may elevate as high as the fourth intercostal space on exhalation, so concurrent abdominal injury must be considered when penetrating trauma is located at or below the fourth intercostal space.

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