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Chest Injuries

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Posted by on Thursday, September 16, 2010, 7:10
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Chest Injuries

Chest injuries are difficult for the first aid provider to manage, and casualties with these injuries should be referred to medical aid as a matter of priority.

Chest Injuries
Chest Injuries

The major chest injuries encountered by the first aid provider are fractured ribs, flail chest and penetrating chest wounds.

Fractured ribs

Ribs are composed of successive layers of flat bone, which give the ribs their flexibility or ‘spring’. When ribs fracture, often the ‘spring’ is reduced, rather than the entire bone being detached from the spinal column or the sternum.

Rib injuries cause distress because the casualty has difficulty breathing.

* history of trauma to the chest
* pale, cool skin
* pain at the site, especially when breathing in
* rapid pulse
* rapid shallow breathing
* ‘guarding’ of the injury

* bind the upper arm on the injured side to the body
* place the arm on the injured side in a ‘collar and cuff’ sling to act as a splint
* seek medical aid
* observe for breathing difficulties

Flail chest

Flail chest is an injury to the ribs where a section of the rib cage has been detached due to multiple fractures. Generally there is an associated collapsed lung (pneumothorax). Flail chest should be considered a life-threatening injury due to its complications.

* pale, cool clammy skin
* rapid, weak pulse
* shallow, difficult breathing
* paradoxical chest movements, where the injured area moves in the opposite direction to the rest of the chest
* cyanosis (bluish skin)
* pain, especially when breathing in

* call ‘000′ for an ambulance
* apply a firm pad over the flail section
* apply a firm bandage in place
* position the casualty in a posture of comfort, usually sitting
* if unconscious, position on the injured side
* reassurance
* observe carefully for signs of breathing difficulties

Penetrating chest wound

A penetrating chest wound is where the object may still be in place in the wall of the chest, or it may be an open wound left by the object, eg a stab wound, or bullet wound.

If the object is still in place DO NOT remove it. If it is too long or too awkward to manage (eg a tree branch), obtain urgent expert assistance and resist removing or cutting the object yourself.

* history of the incident
* object still in place
* open wound in the chest wall (look for both entry and exit wounds)
* pale, cool, clammy skin
* rapid, weak pulse
* rapid, shallow breathing
* cyanosis (bluish skin)
* may be pain at the site
* onset of shock

* call ‘000′ for an ambulance
* if object is still in place, stabilise with a pad around entry wound
* if wound is open, apply plastic or a non-stick pad, taped on three sides only leaving bottom side un-taped to allow for air to escape from the chest. A gloved hand can be also be used to seal the wound until more suitable material is available
* posture casualty in position of comfort
* reassurance
* observe for breathing difficulties

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