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We're going to look at different types of chest injuries and the treatment you may need to deliver. Closed chest injuries can be inherently serious as the chest houses many crucial organs such as the heart, lungs and many major blood vessels. A closed chest injury could be something like where someone's had a car accident and hit their chest hard against the steering wheel. Most chest trauma injuries need urgent medical attention, always call for an ambulance for any potentially serious chest injury. A common result of trauma to the chest is damage to the victim's rib cage. The curved shape of the rib cage helps to deflect the force of some injuries, but damage to cartilage or the ribs themselves can still result. While a single broken rib can be very painful, a number of broken ribs can lead to other complications. A victim with broken ribs may take shallow breaths without even noticing it as their body tries to prevent the pain of taking a full breath. When many adjoining ribs are broken in different places, a portion of the rib cage can move in the opposite direction the chest should. This is known as flail segment and can make breathing very painful and less effective. The signs and symptoms are trouble breathing, shallow breathing, tenderness at the site of injury, deformity and bruising of the chest, pain upon movement, deep breathing, coughing, blue lips or nail beds. They may cough up blood and sometimes a crackling feeling upon touching the victim's skin. The treatment is always to monitor the patient's ABCDs, call for an ambulance, assisting a victim to move into a position, typically seated upright, conduct a secondary survey and monitor the patient's conditions carefully and be vigilant, keep a watch for any changes. An open or sucking chest wound is where the chest has been penetrated by something like a knife, a bullet or falling onto a sharp object. With an open chest wound, you may hear escaping air through the wound. They will have trouble breathing and they will be in pain. You may also see blood in their mouth or they may cough up blood. The treatment for an open or sucking chest wound is to first assess their ABCs, do not remove any embedded objects in the chest, call for an ambulance and lay the patient on their injured side to prevent any complications with their good lung. Treat for shock and carefully monitor them. Rules changed in 2016 on the treatment of sucking chest wounds for first aiders and we no longer use special dressings and the recommendation now is to leave the wound open to the elements. By using dressings, there's a higher risk that you'll do more harm than good. So now, we leave the wound and provide care to the patients and get the emergency medical help there as soon as possible. To summarize, all chest injuries are serious and the first aid you deliver is just to stabilize and reassure the patient before the emergency services arrive.
Chest Injuries: Types, First Aid, and Treatment
Understanding Chest Injuries
Explore the various types of chest injuries and the crucial first aid steps required for each.
Closed Chest Injuries
Closed chest injuries can pose significant risks due to the vital organs housed within the chest cavity. Learn about their nature and the necessary actions:
- Potential Severity: Closed chest injuries can be severe, impacting critical organs like the heart, lungs, and major blood vessels.
- Example Scenario: A person involved in a car accident forcefully strikes their chest against the steering wheel.
- Immediate Action: Most chest trauma cases require urgent medical attention. Always call for an ambulance in cases of potentially serious chest injuries.
Rib Cage Damage
One common consequence of chest trauma is damage to the rib cage. Understand the implications and symptoms:
- Effects: The rib cage's curved structure offers some protection, but damage to cartilage or ribs can still occur.
- Complications: Multiple broken ribs can lead to breathing difficulties as shallow breaths are taken to avoid pain.
- Flail Segment: In severe cases, adjoining ribs breaking in different places can create a "flail" segment, causing painful and less effective breathing.
- Signs and Symptoms: Watch for trouble breathing, shallow breaths, tenderness at the injury site, chest deformities, bruising, pain during movement/deep breathing/coughing, blue lips or nail beds, coughing up blood, and a crackling sensation upon touching the skin.
First Aid for Rib Injuries
Follow these initial steps when dealing with rib injuries:
- Primary Concern: Prioritize monitoring the patient's ABCs (Airway, Breathing, Circulation).
- Call for Help: Request an ambulance promptly.
- Comfortable Position: Assist the victim into a comfortable position, usually seated upright.
- Secondary Survey: Conduct a secondary assessment and closely monitor the patient's condition for any changes.
Open or "Sucking" Chest Wounds
Learn about open chest wounds and the critical actions to take when confronted with this type of injury:
- Description: An open or "sucking" chest wound occurs when the chest wall is penetrated, e.g., by a knife, bullet, or sharp object.
- Distinctive Signs: Listen for escaping air through the wound, and note the victim's breathing difficulties and pain. Blood may be present in their mouth or they may cough up blood.
First Aid for Open Chest Wounds
Follow these immediate actions for open chest wounds:
- Primary Assessment: Begin by assessing the victim's ABCs.
- Do Not Remove Objects: Avoid removing any embedded objects in the chest.
- Request Ambulance: Call for an ambulance without delay.
- Positioning: Lay the patient on their injured side to prevent complications with the good lung.
- Treat for Shock: Provide shock treatment and maintain careful monitoring.
Updated First Aid Guidelines
Important information regarding the treatment of sucking chest wounds has been revised:
- 2016 Rule Change: First aiders no longer use special dressings. The recommendation is to leave the wound open to the elements. Using dressings may pose a higher risk of harm.
- Immediate Care: Prioritize patient care and seek emergency medical assistance as soon as possible.
Summarizing Chest Injuries
Chest injuries are always serious, and initial first aid aims to stabilize and reassure the patient until emergency services arrive.