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© 2016 National Safety Council

CHAPTER 13

Chest, Abdominal and Pelvic Injuries

Chapter 13 • Chest, Abdominal and Pelvic Injuries

1. Explain why chest injuries may be life threatening and list the general signs and symptoms of chest injuries.

2. Describe the specific first aid steps for broken ribs, flail chest, an impaled object in the chest and a sucking chest wound.

3. Describe the signs and symptoms of a closed abdominal injury and the first aid to give.


Lesson Objectives

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4. Explain how to care for an open abdominal wound.

5. Describe the signs and symptoms of a pelvic fracture and the first aid to give.


Lesson Objectives continued

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• Can result from blunt or penetrating forces.

• Can result from any object that breaks the skin.• Can be life threatening.

• Shock often occurs.• Always call 9-1-1.


Injuries to Chest, Abdomen and Pelvis

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Chest Injuries


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Common causes:•

•••••

Striking steering wheel in vehicle crashBlow to chest Fall from a height Sports injury Physical assaultPenetrating injury or impaled object


General signs and symptoms:

• Breathing problems

• Severe pain

• Bruising, swelling

• Deformity

• Coughing blood


General Signs and Symptoms of a Serious Chest Injury

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• Pneumothorax:• Air escapes from injured lung into thoracic cavity

causing collapse of some or all of lung• Results in respiratory distress• Call 9-1-1


Closed Chest Injuries

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• Hemothorax:• Blood from injury accumulates in thoracic cavity,

compressing the lung• Causes respiratory distress and possibly shock• Call 9-1-1


Closed Chest Injuries continued

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• Typically result from blunt trauma

• Common in lower ribs and along the side

• Usually cause severe pain, discoloration and swelling at site

• Injuries to lungs or other underlying organs may also be present with severe trauma

• Always call 9-1-1


Broken Ribs

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First Aid: Broken Ribs

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• Fracture of two or more ribs in two or more places

• Usually results from severe blow to chest• Injury separates segment of chest wall from

remainder of chest


Flail Chest

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Flail Chest continued


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• Paradoxical movement:• Flail segment moves in

opposite direction to rest of chest wall.

• The larger the flail segment, the greater the threat to respiratory function.


1. Help the victim sit in a comfortable position for easiest breathing.

2. Splint the flail area with a small pillow or thick padding loosely bandaged in place (but not completely around the chest).

3. Position the victim lying on the injured side to give more support to the area, unless this causes more discomfort or difficulty breathing.

4. Call 9-1-1.


First Aid: Flail Chest

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1. Keep victim still in the position found.

2. Stabilize the impaled object with bulky dressings.

3. Call 9-1-1.

First Aid: Impaled Object



• Open wound in chest caused by penetrating injury

• Air moves in and out of chest during breathing• Can be life threatening


Sucking Chest Wound

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1. Put a sterile dressing around the wound but do not block airflow into or out of the wound.

2. Position victim lying down inclined toward the injured side, unless this causes more discomfort or difficulty breathing.

3. Call 9-1-1.


First Aid: Sucking Chest Wound

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First Aid: Sucking Chest Wound continued



• Include closed and open wounds.

• Commonly result from blow to abdomen or fall.• May involve internal or external bleeding.

• Ensure immediate medical care.


Abdominal Injuries

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• Can be life threatening.

• Internal organs may have ruptured:• May be severe bleeding.

Closed Abdominal Injury



1. Carefully position the victim on his or her back, and loosen any tight clothing. Bending the knees may relax the abdominal muscles, reducing the pain.

2. Call 9-1-1.

3. Treat victim for shock, monitor the victim’s breathing and be ready to give CPR if needed.


First Aid: Closed Abdominal Injury

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• Usually injures internal organs (intestines, liver, kidneys or stomach)

• Large wound may cause evisceration:• Abdominal organs protruding through wound• Serious emergency


Open Abdominal Wound

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First Aid: Open Abdominal Wound1. Lay victim on back and loosen tight

clothing.

2. Cover wound with moist, sterile dressing or dry non-adherent dressing.

3.Cover with large occlusive dressing.

4. Call 9-1-1.

5. Treat for shock. Monitor breathing and be ready to give CPR if needed.



Pelvic Injuries


• Most common is fractured pelvis.

• More common in elderly:• May occur from fall

• May cause severe internal bleeding:• Life threatening• May cause shock

• Victim may also have a spinal injury.13-25


1. Support the victim in the position found.

2. Call 9-1-1.

3. If help delayed, immobilize legs together.

4. Treat for shock. Monitor breathing and be ready to give CPR, if needed.


First Aid for Pelvic Injuries

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CHAPTER 13

Learning Checkpoint



Chapter – Opening ScenarioThe car in front of you suddenly swerves to the right and runs into the back of a parked car. Fortunately, it was not moving very fast at the time. You pull overand get out to see if you can help. The driver is slumped forward against the steering wheel, apparently not wearing a seat belt and shoulder harness. As youapproach, at first he seems unresponsive, but then he leans back and opens the car door. He gets out, holding his chest on one side and staggers a few feetbefore you reach him. He does not seem to be bleeding, but obviously he is in pain.

What do you do?

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CHAPTER 13

Critical Thinking Challenge Questions


A heavy metal piece breaks loose from machinery in motion and strikes a coworker in the side, knocking him to the floor. He is sitting up, clutching his side and wincing in pain with eachbreath taken. You find heavy bruising beginning a few inches below his armpit but no bleeding or open wounds. He is responsive but says it hurts to breathe or move.

What do you do?


Scenario 1

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An electrician working on wiring behind the ceiling falls off the ladder onto a computer monitor on a desk. The glass of the monitor breaks and slices through the skin over her abdomen.She is still responsive but disoriented and confused. The gash in her abdomen is not bleeding heavily, but a purplish-white organ is pushing through the wound.

How do you care for this victim?


Scenario 2

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An elderly customer loses his grip on his cane and falls, twisting sideways as he hits the floor. He is responsive but pale, unable to stand or move his legs, and says his left hip hurts badly.

What first aid should you give?


Scenario 3

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CHAPTER 13

Discussion and Questions

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