The ideal treatment for hemothorax greater than 500ml/hr
Following are indications of thoracotomy in blunt chest trauma: Initial drainage of blood > 1000 ml, especially if fresh. Continued brisk bleeding > (100 ml/15 minutes) from the intercostal drain Continued bleeding of > 200 ml/hr for > 3 hrs Rupture of bronchus, aoa, esophagus or diaphragm Cardiac tamponade (if needle aspiration unsuccessful). Ref : Bailey & Love 24/e p872
wait and watch
Needle aspiraton
Intercostal tube
Open thoracotomy with ligation of vessels
Cardio thoracic surgery  