Rarely, tube thoracostomy may be urgent to decompress chest. Fluid removed is usually stomach contents and, occasionally, pus, especially if there has been a delay in diagnosis. Patient may be in severe pain. Analgesia may be required and an IV line is necessary. Transport with oxygen in place and on a monitor.
Diagnosis can be difficult but is key to rapid definitive therapy.
As soon as diagnosis is considered, initiate investigation to ascertain site and extent of rupture. Early diagnosis is key to optimum management. Most favorable outcome is obtained by following primary closure within 24 hours. Surgical consultation, most likely cardiothoracic, is mandatory for patients on an emergent basis. Analgesics - Pain control is essential to quality patient care.