Chest injuries can be serious as the chest houses critical organs like the heart and lungs. Most chest trauma requires medical attention. Chest injuries can be either closed or open. Closed chest injuries often involve broken ribs, which can be painful but may become serious if many ribs are broken or a rib segment is flailed. Signs include very shallow breathing. Treatment involves positioning, monitoring, and securing dressings for flail segments. Open chest injuries occur when the chest wall is penetrated, shown by escaping air, entrance/exit wounds, trouble breathing, and blood bubbles with exhalation. Management includes not removing objects, calling for help, applying a flutter valve over wounds, and treating for shock.

1. Chest Injuries
Dr. Kasongo. J

2. • Chest injuries can be inherently serious, as this area of the body
houses many critical organs, such as the heart, lungs, and great blood
vessels.
• Most chest trauma should receive professional medical attention, and
always consider calling for an ambulance for any potentially serious
chest injury.
• Can either be Open or Closed

5. Closed Chest Injury
• A common result of trauma to the chest is damage to the victim's rib
cage.
• The curved shape of the rib cage helps to deflect the force of some
injuries, but damage to cartilage or the ribs themselves can still result.
• While a single broken rib can be very painful for the patient, a
number of broken ribs can lead to other complications.
• A victim with broken ribs may take very shallow breaths without even
noticing it, as their body tries to prevent the pain with taking a full
breath

6. • When many adjoining ribs are broken in different places, a portion of
the rib cage can move in the opposite direction the chest should. This
is known as a "flail" segment, and can make breathing very painful
and less effective

9. Flail Chest Pathology

11. Management
• Assess ABCs and intervene as necessary
• Call for an ambulance
• Assist the victim into a position of comfort (typically seated upright,
to avoid fighting gravity)
• Conduct a secondary survey
• Monitor patient's condition carefully
• Be vigilant, keep alert for any changes in condition.
• If a flail segment is suspected, tightly secure a bulky dressing (such as
a tightly folded hand towel or pillow) to help

13. Open Chest Injuries
• An open pneumothorax or sucking chest wound: –
• This occurs when the chest wall has been penetrated (by knife, bullet,
falling onto a sharp object

14. Diagnosis
• An open chest wound – escaping air
• Entrance and possible exit wound (exit wounds are more severe)
• Trouble breathing
• Sucking sound as air passes through opening in chest wall
• Blood or blood-stained bubbles may be expelled with each exhalation
• Coughing up blood

16. Management
• Assess ABCs and intervene as necessary
• Do not remove any embedded objects
• Call for an ambulance immediately
• Flutter valve over wound, as described below
• Lateral positioning: victim's injured side down
• Treat for shock
• Conduct a secondary survey

17. Flutter Valve
• Get some sort of plastic that is bigger than the wound. Ideas: credit
card or similar, Ziploc bag, some first aid kits will have a ready-to-use
valve.
• Tape the plastic patch over the wound on only 3 sides.
• The 4th side is left open, allowing blood to drain and air to escape.
• This opening should be at the bottom (as determined by the victim’s
position).