Hemothorax
Background
- Each hemithorax can hold 40% of circulating blood volume
Diagnosis
- CXR
- Upright - Fluid collections >200-300cc can usually be seen
- Supine - Fluid collections >1000cc can be missed
- Mainstem bronchus intubation can appear like a hemothorax on CXR
- US
- CT is gold standard
Treatment
- Tube thoracostomy
- Evacuation of >1500mL of blood immediately or 200mL/hr x 4hr = consider sx
- Autotransfuse lost blood if possible