Wound Care – Part 12 “Penetrating or Blunt Chest Injuries”
Wound Care has many parts, lets now look at Penetrating Chest Injuries and the complications they can cause. As we have learned so far chest Injuries can cause breathing emergencies. If the lungs are punctured or damaged by a penetrating object and if the object goes through the rib cage it may let “Air” or “blood” into the chest through the wound. This may force the lungs to inflate inadequately and lead a potentially life threatening emergency such as a “Hemothorax” a “Pneumothorax” or a “Flail Chest”
- – Sudden Falls onto Objects blunt or sharp
- – Industrial incidents involving sharp, blunt or rotating machinery.
- – Any force strong enough to penetrate or create a wound great enough to damage the chests integrity.
- – Altercations involving weapons such as knives or guns.
- – Motor Vehicle accidents
- “Always follow safety guidelines, many injury preventing methods have been put together by Occupational Health and Safety for your personal protection.“
- Chest injuries can often be prevented by good safety practices in all areas of life, this may include:
- – Driving Motor Vehicles – Working around the home
- – Participating in aggressive sports recreational activities
- – Performing occupational activities with heavy, rotating or industrial equipment.
What it Looks Like:
- – Difficulty Breathing
- – Bleeding from an open chest wound
- – Bubbling or a sucking sound coming from the wound in the chest
- – Severe pain on the injury site
- – Coughing up blood
- – Blood bubbling from the wound
- – Gasping with tightness or shortness of breath
- – Shock
- – Guarded Shallow breaths
- – Bruising on the chest or on the injury itself
- – Crunching or grinding sounds in the chest with deformity
- – Uneven rising of the chest during breathing “Flail Chest“
How to Help:
1) Check the area, once the area is safe, Check the person and ensure the persons ABC’s are present “Airway / Breathing / Circulation” REMEMBER – Wear gloves if available to avoid bodily fluids. **If the object is still in the wound “DO NOT REMOVE IT“, however if the object prevents the casualty from breathing “Remove it Immediately” the casualty must be able to breath**
2) Call 911 if you suspect the injuries could be severe, if there are airway could be blocked or there is excessive bleeding. Always call 911 for a penetrating chest wound, there could be internal injuries that may lead to the situation becoming fatal. This may also include Spinal injuries due to the force impacted against the chest.
3) Care for the Chest injury by:
***Only remove the object or the Victim from the object if their Airway could be compromised***
- 1) Have the person rest in a comfortable position
- 2) For a “Penetrating Chest Wound” cover the wound with a dressing that will stop air from getting into the chest. In many first aid kits this bandage is labeled “3 Sided Occlusive Bandage” this is specific bandage for “Penetrating Chest Wounds“. Simply tape the bandage in place with the opening in a position to allow the blood to drain away. Always consult your 911 Dispatcher for more information on current 2015 guidelines and what you may be able to do to help.
- 3) Perform a Secondary Survey “Second Chance to find injuries” and treat any non life threatening conditions. With a “Flail Chest” often having the casualty hold something bulky against their chest “Such as a rolled up towel” may help hold the rib cage in place.
- 4) Continue to provide care until further help arrives “EMS Personnel“
“Pneumothorax & Hemothorax”
A Pneumothorax is a condition where “Air” enters the chest cavity from the wound site but does not enter the lung. The air in the chest cavity presses against the lung, causing it to collapse or be restricted from expansion. A Hemothorax in like condition is where “Blood” accumulates in the chest cavity from the wound site but does not enter the lung. Because blood and air take up space in the chest cavity, the lungs are unable to expand effectively, thus leading to damage or limiting respiration’s and becoming potentially fatal injury.
A Flail Chest is a condition where 3 or more ribs are fractured in two or more places releasing the rib fragments from the chest wall, resulting in a “Flail Chest” The segment will move opposite that of the normal chest movement with visible deformity. Breathing with a Flail Chest may be extremely Painful and difficult and often does not allow for adequate oxygenation of the body, The severity of the condition and may become fatal if there are underlying conditions or internal injuries associated with the Chest Injury.
We never know what can happen, its always good to be prepared and have the knowledge we need to help those who need it.
“This material is for information purposes only and is taken from The Canadian Red Cross / Alberta Heart & Stroke Foundation & Alberta Health Services. This information should not be used in place of medical, Technical advice, instructor, and/or treatment. If you have questions, speak to your local Physician or Safety Training Facility.”
Protect Yourself!!! Call 911!!! Don’t Waste Time!!!