1 Chest Injuries Pakistan ICITAP

2 Learning Objectives Be familiar with the anatomy contained in the chest Identify signs and symptoms of different life threatening chest injuries Understand the difference between open and closed chest injuries (penetration and blunt trauma) Learn First Aid treatment for chest injuries

3 Introduction As Police Officers, you will be exposed to chest injuries resulting from accidents, assaults, combat or explosions The victim of a chest injury must be treated at a medical facility as soon as possible A knowledge of First Aid can often mean the difference between life and death

4 Two types of Chest Injuries OPEN: As a result of an accidental or deliberate penetration of a foreign object into the chest (for example: knife wound, shrapnel) CLOSED: Chest injury can also result from a blunt trauma (for example: punch, kick, or other object forced upon the chest)

Chest Injuries Penetrating Blunt

6 Recognizing Chest Injuries The chest contains many critical organs such as the heart, lungs, and great blood vessels Injuries to the chest can be difficult to recognize and may go unnoticed until they become very serious During trauma, these organs may tear, often bleeding at a slow enough rate to be overlooked

7 Vital Organs of the Chest

8  There are many different types of Chest Injuries  The three most life-threatening are:  Collapsed lung (Closed)  Flail chest (Closed)  Sucking Chest wound (Open) Life Threatening Chest Injuries

9 Collapsed Lung

10 Air enters the lung causing it to collapse Common causes:  Puncture wounds of the chest  Broken rib that punctures a lung  Asthma or infections Collapsed lung

11 Healthy lung Collapsed lung

12 Signs and Symptoms of collapsed lung  The bigger the collapse of the lung, the worst the signs will be  Severe/sudden sharp chest pain at site of lung collapse  Difficulty breathing/shallow and rapid  Bluish skin color  Signs of Shock

13 Treatment  Call for ambulance  Assess ABC’s and treat as necessary  Manage chest wound according to injury  Loosen any tight clothing  Place patient in position of comfort (usually sitting up) or in Recovery Position with injured side closest to ground

Place victim in Recovery Position, with injured side closest to the ground, or place in position of comfort

15 Flail Chest

16 Flail Chest  Flail Chest occurs when 2 or more ribs break at both ends and become separated from the chest wall  Flail Chest is also known as “Floating Ribs”  The sharp, broken ribs can puncture a lung or the heart, resulting in death

17 Signs and Symptoms of Flail Chest Trouble breathing/Shallow breathing Bruising/Swelling of chest Crackling feeling upon touching victim’s skin (sounds and feels like crunching cereal) May cough up blood

18 Treatment  Assess ABCs and treat as necessary  Use gloved hand as splint until bulky dressing can be put on patient  The flail area should be supported by a firm chest wrap  Place patient in position of comfort (usually sitting up) or in Recovery Position with injured side closest to ground

19 Place victim in Recovery Position, with injured side closest to the ground, or place in position of comfort

Flail Chest 20

21 Sucking Chest Wound

22 An OPEN chest wound allowing air to escape out of the lungs. The escaped air causes a “sucking” sound. Sucking Chest Wound

23 Signs and Symptoms of Sucking Chest Wound Trouble breathing Increased anxiety Sucking/hissing sound as air passes through chest wall Bloody bubbles may be present at wound site Coughing up blood

24 Treatment Call for Ambulance Assess ABC’s and treat as necessary DO NOT REMOVE any protruding objects, such as knife, wood or shrapnel Place plastic cover over wound:see below Placed victim on side, with the injured side closest to the ground Treat for shock

25 Dressing a Sucking Chest Wound Use plastic or tight cover that is slightly bigger than wound, Example: ziplock bag, credit card, aluminum foil Tape the plastic cover over the wound on only 3 sides. The 4 th side remains UNTAPED. It must be left open to allow blood to drain and air to escape Always check for exit wound and treat as needed

26 Use hand to cover wound while preparing the seal. Plastic wrapper of battle dressing works well.

27 Apply plastic large enough to extend beyond the edges of the wound. A smaller patch would get pulled into wound.

28 Place dressing over seal, securing with tape. Only 3 sides are taped.

29 Bandage in place, ensuring it is not too tight to interfere with breathing

30 Place victim in Recovery Position with injured side closest to the ground

31 Sucking Chest Wound

32 Principles of Care For Chest Injuries  Chest injuries are common and often life threatening. Different types of chest injuries often produce similar symptoms.  Airway Management is vital!  Apply dressing to wound as needed. Monitor for signs of shock.  Rapid Transport! Remember a True Emergency!

33 Review What vital organs are contained in the chest? Describe the difference between open and closed chest injuries Identify different life-threatening chest injuries Demonstrate first aid treatment for each type of life threatening chest injury

34 Questions?

35 Class Practical Exercise Practice some of the skills shared in this presentation