65.8 Stab wounds of the chest

You may have great difficulty deciding how deep a stab wound is, or which organs in a patient’s chest or abdomen have been pierced or are bleeding. If there is air or blood in his pleural cavity, drain them. He will need a thoracotomy: (1) If blood continues to drain from his chest, because it may be coming from his lung, or some other organ inside his thorax. (2) If the stab wound is over his heart or the great vessels at the root of his neck. (3) When an underwater seal drain has failed to slow the loss of blood.