A 3-YEAR-OLD boy was brought by paramedics to the emergency department with a penetrating chest injury. He had been unintentionally stabbed with a barbecue skewer by his 11-year-old sister. On arrival, he was awake and alert with a blood pressure of 116/60 mm Hg, heart rate of 122/min, respiratory rate of 22/min, and a room air oxygen saturation of 100%. The trachea was midline, breath sounds were clear bilaterally, and heart sounds were normal. The skewer entered the skin below the left lateral clavicle and its tip was tenting the skin on the patient's left upper back. The neurovascular system of the upper extremities was intact and there was no visible bleeding. Results of the remainder of the physical examination were unremarkable.
Anteroposterior and lateral chest radiographs were obtained (Figure 1 and Figure 2). Arteriography was performed (Figure 3).
Denouement and Discussion
Penetrating Chest Trauma in Children
Injuries are the