Of the nearly 58,000 cases reported that year, 3,145 died and 21,269 were left with mild to disabling paralysis. Intensive care medicine has its origin in the fight against polio. Most hospitals in the 1950s had limited access to iron lungs for patients unable to breathe without mechanical assistance. Respiratory centers designed to assist the most severe polio patients, first established in 1952 at the Blegdam Hospital of Copenhagen by Danish anesthesiologist Bjørn Ibsen, were the precursors of modern intensive care units (ICU). (A year later, Ibsen would establish the worlds first dedicated ICU. )The polio epidemics not only altered the lives of those who survived them, but also brought profound cultural changes, spurring grassroots fund-raising campaigns that would revolutionize medical philanthropy, and giving rise to the modern field of rehabilitation therapy. As one of the largest disabled groups in the world, polio survivors also helped to advance the modern disability rights movement through campaigns for the social and civil rights of the disabled. The World Health Organization estimates that there are 10 to 20 million polio survivors worldwide. In 1977, there were 254,000 persons living in the United States who had been paralyzed by polio. According to doctors and local polio support groups, some 40,000 polio survivors with varying degrees of paralysis were living in Germany, 30,000 in Japan, 24,000 in France, 16,000 in Australia, 12,000 in Canada and 12,000 in the United Kingdom in 2001.
A chest injury, also known as chest trauma, is any form of physical injury to the chest including the ribs, heart and lungs. Chest injuries account for 25% of all deaths from traumatic injury. Typically chest injuries are caused by blunt mechanisms such as direct, indirect, compression, contusion, deceleration, or blasts- caused by motor vehicle collisions or penetrating mechanisms such as stabbings. Classification
Chest injuries can be classified as blunt or penetrating. Blunt and penetrating injuries have different pathophysiologies and clinical courses. Specific types of injuries include:

Injuries to the chest wall
Chest wall contusions or hematomas. Rib fractures
Flail chest
Sternal fractures
Fractures of the shoulder girdle
Pulmonary injury (injury to the lung) and injuries involving the pleural space
Pulmonary contusion
Pulmonary laceration
Pneumothorax
Hemothorax
Hemopneumothorax
Injury to the airways
Tracheobronchial tear
Cardiac injury
Pericardial tamponade
Myocardial contusion
Traumatic arrest
Hemopericardium
Blood vessel injuries
Traumatic aortic rupture
Thoracic aorta injury
Aortic dissection
And injuries to other structures within the torso
Esophageal injury (Boerhaave syndrome)
Diaphragm injury

Diagnosis
Most blunt injuries are managed with relatively simple interventions like tracheal intubation and mechanical ventilation and chest tube insertion. Diagnosis of blunt injuries may be more difficult and require additional investigations such as CT scanning. Penetrating injuries often require surgery, and complex investigations are usually not needed to come to a diagnosis. Patients with penetrating trauma may deteriorate rapidly, but may also recover much faster than patients with blunt injury. See also
Transmediastinal gunshot wound
Commotio thoracis

References


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