شاب عمره ٢٥ سنة بعد طعنة في الصدر، ضيق نفس وأصوات التنفس غائبة في اليسار. وُضع له أنبوب صدر فخرج ١٦٠٠ مل دم مباشرة، وما زال ينزف. الضغط ٨٢/٥٠، والنبض ١٣٦. ما المتوقع؟

A 25-year-old with a stab wound to the chest is breathless with absent left breath sounds. A chest tube immediately drains 1,600 mL of blood and continues to bleed. BP 82/50, HR 136. What is expected?

1. Monitor drainage and wait until morning
2. Clamp the tube to stop the bleeding completely
3. Remove the tube because it caused the bleeding
4. Inform the surgeon at once for likely thoracotomy

Answer: D) Inform the surgeon at once for likely thoracotomy. An initial drainage over 1500 mL, or continuing around 200 mL/h, in haemothorax signals major bleeding usually needing thoracotomy. Blood is given and theatre prepared.