A systematic approach is used to identify immediate and potentially life-threatening thoracic trauma. The assessment of breathing is key: in the field of play including; respiratory rate, expansion and chest wall tenderness. In the medical room a more thorough examination including respiratory rate, expansion, percussion and auscultation with the monitoring of oxygen saturations with a pulse oximeter (where available). This approach will allow the practitioner to identify the conditions highlighted in this chapter and to either treat them appropriately or facilitate rapid, safe transfer to definitive care for treatment. Transfer to an emergency department to specialist care should be undertaken at the earliest opportunity, once safe to do so with trained personnel and equipment.