Lesson 6: Lesson 6: Chest Injuries Chest Injuries

Emergency Reference Guide p. 47-50Emergency Reference Guide p. 47-50

ObjectivesObjectives• Demonstrate a field assessment of a person

with a chest injury• Describe the emergency treatment and long

term care of:– Fractured rib/clavicle – Pneumothorax– Tension pneumothorax– Fail Chest– Sucking Chest Wound– Describe when to evacuate SLOW vs. FAST

Checking and Caring for Chest Checking and Caring for Chest InjuriesInjuries

• What are Signs & Symptoms of a Chest injury?– Deformity, Open wounds, Tenderness, Swelling

(DOTS)– Windpipe pushed to one side of neck– Abnormal breathing– Bleeding or holes with/without bubbles, bruising– Unusual noises like gurgling or air escaping– Abnormal chest rise

Checking & Caring for Chest Checking & Caring for Chest Injuries Injuries (cont’d.)(cont’d.)

• Signs & Symptoms (cont’d.)

– Patient is guarding a particular area– While exerting some pressure with hands you

• Hear cracking sounds • Feel/hear crumbling• Find depressions

– Patient has point pain/tenderness along ribs or clavicle (aka collarbone)

Chest InjuriesChest Injuries

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Chest InjuriesChest Injuries

Rib InjuriesRib Injuries

• What are the Signs & Symptoms?– Pain in the clavicle or rib area– Complaints of increased pain with deep

breathing– Discoloration, bruising or swelling – Guarding the injury from being

touched/moved– Specific point where pain is most intense

Rib Injury TreatmentRib Injury Treatment

• Protect simple fracture by:– Supporting arm on injured side with sling &

swath– DO NOT band snugly around patient’s chest– Encourage patient to take regular deep

breaths to keep lungs clear of fluid– Try padding area to increase comfort

Rib Injury CareRib Injury Care

Lung InjuriesLung Injuries• Lung injuries can lead to pneumothorax

(air trapped in chest).

– Leads to:• Difficulty breathing & rising anxiety

• Pneumothorax can worsen until patient cannot breath adequately (i.e. tension pneumothorax)

• Suspicion of pneumothorax requires immediate (FAST) evacuation

• No treatment available in wilderness setting for a lung injury

Flail ChestFlail Chest

• Ribs broken in several places, free floating bones

• Flail section moves in opposition to rest of chest• Not common, can be life-threatening, immediate

evacuation necessary• May need to give rescue breaths• Applying bulky dressing may allow patient to

breath easier. Do not wrap chest with tape

Sucking Chest WoundSucking Chest Wound

• Characterized by open wound that bubbles & makes noises when breathing

• Do not remove impaled objects. Immobilize & seal wound(s)

• Apply Occlusive dressing– Apply Air barrier (i.e. plastic baggie, etc.)

• One corner is left open to allow air to escape

Guidelines for EvacuationGuidelines for Evacuation

• GO SLOW with suspected rib fracture. Patient may walk:– Must be evaluated by health care provider– Patient may have difficulty breathing

• GO FAST & transport patient for:– Increase difficulty breathing– Flail chest– Sucking chest wound– Transport on side with injury or other position of

comfort.

Preventing Chest InjuriesPreventing Chest Injuries

• Prevention is important, since no effective field treatment is available in field

SHOUT OUTSHOUT OUT

• What are some possible chest injuries you can anticipate in a Wilderness or remote location?

• What are some smart ways to help prevent chest injuries?

Questions?Questions?

What else can be added to the First Aid Kit?What else can be added to the First Aid Kit?