First Aid Chest Injuries.

Lauren Matthews

Year 11 PDHPE

ASSESSMENT TASK; 4

The nature of the medical injury/condition.

Chest injuries are injuries and conditions which are located in and around the chest area. The chest area includes places such as the rib cage, lungs, upper abdomen, sternum etc. There are many different types of chest injuries which can occur. The following are just a few examples of the major chest injuries and what happens when a person experiences these conditions or injuries.

Flail chest;

A flail chest injury is an injury which occurs to the ribs. This is where a section of the rib cage is detached due to multiple fractures and the injured part of the chest is floating free.

This is normally associated with a collapsed lung. The part of the chest wall which is injured is called the flail or loose segment. Flail chest could be a life-threatening injury due to its complications. This particular chest injury is classified as a closed chest injury.

Penetrating chest wound;A penetrating chest wound occurs when an object penetrates through the flesh into the chest area.

This can cause severe internal damage within both the chest and the upper abdomen. The lungs are also very vulnerable to injury. If a puncture is deep enough, the rib cage may be penetrated allowing air to enter the chest through the wound its self. If air enters the pleural cavity the lung on the side of the injury will collapse. When this happens it is called an open or traumatic pneumothorax. Pressure in the chest cavity may build up to such an extent that the heart is pushed to the side causing the uninjured lung to also be affected. The build-up of pressure may also prevent adequate refilling of the heart, impairing the blood supply and causing shock. This particular chest injury is classified as an open chest injury.

Fractures to the ribs;

When the ribs fracture, the ‘spring or flexibility’ is reduced, rather than the entire bone detaching from the spinal column (broken ribs)

Ribs are made up of successive layers of flat bone, which give them their flexibility or their ‘spring’. All rib injuries can cause great distress to the casualty as they have difficulty breathing. This type of chest injury is classified as a closed chest injury.

Collapsed Lung;This occurs when air enters the area outside the lungs , raising the pressure above that inside the lungs which causes a section of the lung to collapse.

A collapsed lung is also known as a pneumothorax. If the air continues to enter the area outside of the lungs and can not escape, it can cause further collapse to the lung. A collapsed lung can occur spontaneously, from a trauma or as a result of over pressurisation of the lungs.

Sucking or Open Chest Wound;A result from a chest injury where the wound has penetrated the chest wall, through to the pleural space (space around lungs) and into the lung.

This can then allow air to be sucked into the chest cage on inspiration, which could possibly cause a tension pneumothorax (when air enters the pleural and can’t scape cause a collapsed lung).

Sign’s and Symptoms.

Flail chest ;•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.

Penetrating chest wound;•Pain at the site of wound•Unconsciousness•Difficult and painful breathing•Bloodstained bubbles around wound when casualty exhales

•Sounds of air being sucked into chest as the casualty exhales.

Fractured ribs;•Pain- worsens when the casualty breathes or coughs.•Tenderness at site of injury.•Short, rapid breathing.•Frothy, bloodstained sputum.

Collapsed lung;• Serve chest pain• Serve breathing difficulty• Bluish skin colour• Reduced level of consciousness• Enlarged neck veins• Reduced chest movement on injured side

Sucking or Open Chest Wound;• Open wound to the chest• Serve breathing difficulty• Sound of air being sucked in through wound

Current primary management techniques.

Penetrating chest wound;1. Follow DRABCD.

2. Place casualty in a setting position with affected side down.

3. Cover the wound- use the casualty’s or your own hand to stop air flowing in and out of chest cavity.

4. Cover wound with a dressing such as plastic sheet, bag or aluminium foil- if not available, use a sterile dressing or pad.

5. Seal with tape on three sides (not the bottom).

6. Call 000 for an ambulance.

NOTE: check for an exit wound, especially if caused by a velocity trauma e.g. gunshot wound.

Fractured ribs;

Conscious casualty:1. Place in a comfortable position (normally half-sitting and leaning to the injured side,

if other injuries permit).

2. Encourage the casualty to breathe with short breaths.

3. Gently place ample padding over the injured area.

4. Apply one or two broad bandages (depending on size of the casualty), securing arm and padding to chest on injured side.

5. Tie bandages in front on uninjured side.

6. If bandage increases discomfort, loosen or remove them.

7. Immobilise the arm using a sling or collar and cuff sling.

8. Call 000 for an ambulance.

Unconscious casualty:1. Follow DRABCD.

2. Lie casualty on injured side, in recovery position.

3. Call 000 for an ambulance.

Flail chest;

1. Follow DRABCD.2. If casualty is conscious, place in a comfortable position- normally half sitting, leaning

to the injured side. If casualty is unconscious, turn to the injured side, in recovery position.

3. Loosen tight clothing.4. Place a large bulky dressing over the loose area with a firm bandage.

5. Call 000 for an ambulance.

Collapsed lung;

The first aid management for treating a collapsed lung is to:• Seek immediate medical aid 000.

• DRABCD.• Provide oxygen provision if available.

Sucking or Open Chest Wound;

1. Call 000.

2. Help victim into a semi-recumbent position with injured side downwards.

3. Cover the wound site with some air tight material. If possible, the dressing should be taped

on three sides leaving the bottom edge free. This will stop the air being sucked in but will

allow trapped air to escape.

4. Provide supplemental oxygen is able.

5. Monitor the victim continuously and continue to reassure them.

6. If the victim becomes unconscious, conduct a Primary Survey (DRABCD).

Website: (online)http://www.parasolemt.com.au/chestinjuries.aspWednesday 30th July 2008 5.40pm

Book: Australian First Aid

Author: St John Ambulance Australia

Book:

Royal Life Saving First Aid

Author: John Lippmann and David Natoli

BIBLIOGRAPGHY: