Chest injuries can be classified as open or closed. An open chest injury occurs when the integrity of the skin has been broken and the chest wall is penetrated by objects commonly by knife or bullet. A closed chest wound on the other hand is a wound sustained on the chest without any object penetrating the skin’s surface and is usually blunt in nature.
A responsive chest injury victim can be assisted to sit up or if the injury is on either side can be positioned on the injured side down. This position normally would prevent blood inside the chest cavity from pooling into the uninjured side and more importantly allow the uninjured side to have enough space to expand when breathing.
Recognizing Rib Fractures
Rib fractures are basically closed chest injuries and the most common type of rib fracture are the ones caused by a hard blow or a fall with the chest sustaining much of the force. A flail chest, for example results when several ribs in the same place are fractured in one place. The care for isolated rib fractures and flail chest are the same. The signs of a rib fracture include any of the following:
- Shallow breathing.
- Sharp pain especially when victim takes a deep breath, coughs and moves.
- Victim constantly holds his/her chest in trying to alleviate pain.
Care for Rib Fractures
To care for a victim with a suspected rib fracture, do the following:
- Assist the victim in finding the most comfortable resting position to make breathing much more comfortable as easier.
- Instruct the victim to stay still as possible to prevent possible puncture of rib shrapnel to the lung cavity.
- Stabilize the ribs by splinting the chest with a soft object against the injured area or use bandages to hold the pillow in place.
- Contact emergency medical services for further care and management.
Impaled Object to the Chest
Impaled objects are the more obvious open chest injuries wherein an object such as a knife or a similar sharp material is struck in the chest and is embedded in the underlying tissue. Impaled chest wounds are life threatening injuries mainly because of the close proximity of the area to the lungs and heart; two vital organs that when injured can lead to death within a matter of minutes.
Care for an impaled object to the chest
- Do not attempt to remove the embedded object. Removing the impaled object might cause more damage and profuse bleeding.
- When moving the victim, carefully assist the victim to a comfortable position slowly without dislodging the impaled object.
- Use bulky dressings (clean cloth sterile packs) to wrap around the object for stability.
- Immediately call emergency medical services for further medical management.
Recognizing a sucking chest wound
A sucking chest wound occurs when an injury through the chest allows air to pass into and out the chest cavity with each breath the victim takes. Signs of a sucking chest wound include:
- An open or punctured chest wound.
- Blood bubbling out of the chest wound.
- Sound of air being sucked into and out of the chest wound.
Care for a sucking chest wound
To care for a sucking chest wound:
- Seal and stabilize the wound with plastic or aluminum foil to prevent air from entering the chest cavity.
- If the victim has trouble breathing or his/her condition is getting worse, remove the covering to let air escape and reapply the cover once victim breathes comfortably.
- Position the victim on the injured side to prevent pooling of blood to the unaffected part of the chest.
- Contact emergency medical services.
Alton, T. et al (2012). First Aid, CPR and AED Standard 6th Ed. Jones & Bartlett Learning