1. Chest, Abdominal, and Pelvic Injuries
Chapter 13
Chest, Abdominal, and
Pelvic Injuries 1

2. Chest Injuries Open or closed
All victims should have their airway, breathing, and circulation checked.
A responsive victim should sit up or be placed with injured side down.

3. Closed Chest Injuries
In a closed chest injury, the skin is not broken.

4. Rib Fractures
The upper four ribs are protected by the collarbone and shoulder blades.
The lower two ribs, “floating ribs,” have freedom to move.
Broken ribs usually occur along the side of the chest.

5. Recognizing Rib Fractures
Sharp pain (deep breath, coughing, or moving)
Victim holds injured area.
Victim reports being hit where there is pain.
Area is tender.
Shallow breathing
Gently press inward on both sides of the chest at the same time to assess for a rib fracture.

6. Care for Rib Fractures Help victim find a comfortable position.
Stabilize the ribs with a pillow or similar object.
Give pain medication.
Seek medical care.

7. Flail Chest
Flail chest involves several ribs in the same area broken in more than one place.
Paradoxical movement is when the area over the injury moves in a direction opposite to that of the rest of the chest wall during breathing.

8. Recognizing Flail Chest
Paradoxical chest motion takes place.
Breathing is very painful and difficult.
Bruising may occur.

9. Care for Flail Chest Support the chest. Monitor breathing.
Apply hand pressure.
Place victim on injured side with blanket underneath.
Monitor breathing.
Seek medical care.

10. Open Chest Injuries
An open chest injury is when the skin has been broken and the chest wall is penetrated.

11. Impaled Object in the Chest
An impaled object penetrates the chest wall.
Causes air and blood to escape into the space between lungs and chest wall
Lung collapses.
Can lead to shock and death

12. Recognizing an Impaled Object in the Chest
Usually easy to see
Object may be below skin surface.
Look for hidden objects.

13. Care for an Impaled Object in the Chest
Stabilize the object in place with bulky dressings.
Do not try to remove the object.
Call

14. Sucking Chest Wound
A sucking chest wound results when a chest wound allows air to pass into and out of the chest with each breath.

15. Recognizing a Sucking Chest Wound
Blood bubbling out of chest wound during exhalation
Sucking sound during inhalation

16. Care for a Sucking Chest Wound
Seal the wound.
Plastic wrap or plastic bag
Tape plastic in place; leave one side open.
Drain to gravity.
Lean or lay victim on injured side.
Remove plastic if victim has trouble breathing or seems to be getting worse.
Call

17. Abdominal Injuries
Abdominal injuries are either open or closed and can involve hollow and/or solid organs.
Hollow organ rupture spills contents of organ into abdomen.
Solid organ rupture results in internal bleeding.

18. Closed Abdominal Injury
Closed abdominal injuries occur when the internal abdominal tissues are damaged but the skin is unbroken.
Also known as blunt injuries

19. Recognizing a Closed Abdominal Injury
Gently press all four quadrants of the abdomen.
Notice:
Bruises or marks
Pain, tenderness, muscle tightness, or rigidity
Distention (swelling)

20. Care for a Closed Abdominal Injury
Unresponsive:
Responsive:
Place victim on left side in comfortable position with legs bent (“fetal position”).
Call
Place victim on one side in comfortable position with legs slightly bent.
Call

21. Open Abdominal Injury
Open abdominal injuries are those in which the skin has been broken.
Also known as penetrating injuries
Always serious
Usually cause internal organ damage

22. Care for a Penetrating Wound
Stabilize the penetrating object.
Place bulky dressings around object.
Do not try to remove object.
Call

23. Protruding Organs Also called an evisceration
Severe injury in which internal organs escape or protrude from wound

24. Care for Protruding Organs
Call
Allow victim to stay in comfortable position.
Legs pulled toward abdomen
Cover protruding organs.
Treat for shock.

25. Pelvic Injuries
Pelvic fractures are usually caused by falling or a motor vehicle crash.

26. Recognizing Pelvic Injuries
Pain in hip, groin, or back
Increases with movement
Inability to stand or walk
Signs of shock
Check pelvis by gently pressing inward and downward on tops of hips.

27. Care for Pelvic Injuries
Treat the victim for shock.
Place padding between victim’s thighs.
Tie victim’s knees and ankles together.
Keep victim on a firm surface.
Call