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Twenty five per cent of trauma deaths are directly caused by injury to the thorax and, while a minority will require emergency surgery, up to eighty five per cent of chest injuries can be managed without the need for formal surgical intervention.¹ In these cases, rapid recognition and management of life-threatening conditions are key to successful resuscitation.

Thoracostomy (the creation of an artificial opening in the chest wall) is a procedure performed for decompression of the chest, usually by our pre-hospital, surgical or emergency medicine colleagues. It is also the first stage to placing a tube thoracostomy or ‘open’ chest drain. In the context of trauma, emergency lateral thoracostomy is indicated in the following circumstances:

• traumatic tension pneumothorax
• massive haemothorax
• traumatic cardiac arrest.

This first report, an assessment of the scientific basis of climate change and its impacts and future risks, highlighted the importance of climate change as a global challenge with universal consequences which required international collaboration, cooperation and action.

Unfortunately, all these years later we haven’t made as much progress as we should have done across the world. The latest (2023) Lancet Countdown Report 'underscores the imperative for a health-centred response in a world facing irreversible harms. Climate inaction is costing lives and livelihoods today, with new global projections revealing the grave and mounting threat to health of further delayed action on climate change’. How can we take action? What can we do? You can all achieve so much more than you believe, and we would like to guide, support and empower you to do so.

It's time for us to take action together.