Breathing

All patients should receive high-flow oxygen and be continuously monitored by pulse oximetry. Proximity of the base of the neck and the thorax predisposes both regions to injury. Difficulty ventilating a patient is indicative of either upper airway or thoracic injuries. Unequal breath sounds and asymmetric chest movement are signs of inadequate ventilation. These signs are associated with pneumo- or hemothoraces. Tracheal deviation may accompany a tension pneumothorax. Prompt recognition of these life-threatening complications and treatment with a tube thoracostomy will ensure adequate ventilation.

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