ch13

1. Chapter 13
Chest, Abdominal, and
Pelvic Injuries

2. Chest Injuries
• Open or closed
• All people with chest injuries should have
airway, breathing, and circulation checked
and rechecked.
• A responsive person 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
muscles, 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. Rib Fractures: What to Look For
• Sharp pain when person takes deep
breaths, coughs, or moves
• Guarding
• Tenderness
• Shallow breathing
• Bruising of skin over injury

6. Rib Fractures: What to Do
• Help person find a
comfortable position.
• Stabilize chest.
• Give pain medication.
• Have person take very
deep, slow breaths.
• Call 9-1-1.
© American Academy of Orthopaedic Surgeons.
© American Academy of Orthopaedic Surgeons.

7. Flail Chest: What to Look For
• Paradoxical chest motion
• Very painful and difficult breathing
• Bruising of skin over the injury
• Same signs as for rib fractures

8. Flail Chest: What to Do
• Do not apply constrictive bandages around
the chest.
• Call 9-1-1.

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

10. Sucking Chest Wound
• What to look for
− Blood bubbling out of chest wound
− Sucking sound during inhalation
• What to do
− Leave the wound exposed to air.
− Do not cover unless using direct pressure and
a dry gauze dressing to control bleeding.
− Call 9-1-1.

11. Impaled Object in the Chest
• What to look for
− Usually easily
recognized
• What to do
− Stabilize the object
in place with bulky
dressings.
− Call 9-1-1.
© American Academy of Orthopaedic Surgeons.

12. 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.

13. Closed Abdominal Injury
• Occur when the
internal abdominal
tissues are
damaged but the
skin is unbroken
• Examine by gently
pressing all four
quadrants. © Jones & Bartlett Learning.

14. Closed Abdominal Injury
• What to look for
− Bruises or other marks
− Pain, tenderness, muscle tightness, or rigidity
− Distention
• What to do
− If unresponsive, place in recovery position.
− If responsive, place in side-lying position.
− Call 9-1-1.

15. Open Abdominal Injury
• Open abdominal injuries are those in
which the skin has been broken.
− Also called penetrating injuries
• Stab wounds
• Gunshot wounds

16. Penetrating Injury: What to Do
• Stabilize object against movement and
control bleeding by placing bulky
dressings around it.
• Call 9-1-1.
© Jones & Bartlett Learning. Courtesy of MIEMSS. © Jones & Bartlett Learning. Courtesy of MIEMSS.

17. Protruding Organs: What to Do
• Have person stay in comfortable position
with legs pulled toward abdomen.
• Cover organs with a moist, clean dressing.
• Call 9-1-1.
© Jones & Bartlett Learning. Courtesy of MIEMSS.

18. Pelvic Injuries
• Pelvic fractures are usually caused by
falling or a motor vehicle crash.
• Check pelvis by gently pressing inward
and downward on the tops of the hips.
− If pain results, suspect a fracture.

19. Pelvic Injuries: What to Look For
• Pain in the hip, groin, or back that
increases with movement
• Inability to stand or walk
• Signs of shock

20. Pelvic Injuries: What to Do
• Call 9-1-1.
• Do not move person.
• Keep person lying flat.
• Treat for shock.