Hemothorax

Massive hemothorax by definition is an immediate loss of 1500 cc or more of blood into the chest cavity and may occur from blunt or penetrating trauma. A cell saver Hemovac type suction apparatus, in which blood can be transfused immediately back into the patient is helpful in this situation. Operation should be performed for such exsanguinating blood loss early in the patient's management. If the patient is hypotensive, immediate operation is needed, sometimes even by thoracotomy in the emergency room if the patient is agonal.

Blood loss exceeding 1000 cc over the next hour or more than 500 cc each hour over the next 2 hours or more than 300 cc each over the next 3 hours generally requires thoracotomy, since a surgical correctable problem is usually identified.

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