{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T14:20:06Z","timestamp":1785421206961,"version":"3.56.0"},"reference-count":17,"publisher":"IMR Press","issue":"10","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Br J Hosp Med"],"published-print":{"date-parts":[[2022,10,2]]},"abstract":"<jats:p>Major trauma networks reduce mortality in critically injured patients. Trauma patients should be appropriately triaged straight from the scene of injury, avoiding secondary transfer from a trauma unit. Selection criteria in regionally agreed triage tools are designed to identify which patients should be taken directly to the major trauma centre. Patients with life-threatening injuries still arrive at \u2018trauma units\u2019 in circumstances such as self-presentation, under triage, physiological instability or long journey time to the major trauma centre.<\/jats:p>\n                  <jats:p>This article presents a theoretical case of a haemodynamically unstable patient with penetrating injuries, and discusses the management of chest trauma, including diagnosis of life-threatening injuries, resuscitation strategies and definitive surgical management. Secondary transfer to the major trauma centre should be considered after instituting the minimal life-saving interventions. What constitutes a life-saving intervention requires an individual dynamic risk assessment and an understanding of major trauma networks.<\/jats:p>","DOI":"10.12968\/hmed.2022.0002","type":"journal-article","created":{"date-parts":[[2022,10,31]],"date-time":"2022-10-31T11:56:31Z","timestamp":1667217391000},"page":"1-7","source":"Crossref","is-referenced-by-count":2,"title":["Management of penetrating chest trauma in the context of major trauma networks"],"prefix":"10.31083","volume":"83","author":[{"given":"Benjamin","family":"Stretch","sequence":"first","affiliation":[{"name":"London School of Anaesthesia, Royal London Hospital, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy","family":"Kyle","sequence":"additional","affiliation":[{"name":"East of England Ambulance Service NHS Trust, Cambridge, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mihir","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia, Barking, Havering and Redbridge University Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"16242","reference":[{"key":"B1","unstructured":"American College of Surgeons. 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Major trauma: assessment and initial management. London: National Institute for Health and Care Excellence; 2016"},{"key":"B10","unstructured":"NHS East of England Trauma Network. TEMPO \u2013 Trauma East manual of procedures and operations. 2nd edn. Cambridge: NHS East of England Trauma Network; 2014"},{"issue":"10","key":"B11","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3310\/hta17100","volume":"17","author":"Roberts I","year":"2013","journal-title":"Health Technol Assess"},{"key":"B12","unstructured":"Royal College of Emergency Medicine. Traumatic cardiac arrest in adults. London: Royal College of Emergency Medicine; 2019"},{"key":"B13","unstructured":"Royal College of Radiologists. Standards of practice and guidance for trauma radiology in severely injured patients. 2nd edn. 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