Chest, Abdominal, and

1
Chapter 13

• Chest, Abdominal, and
• Pelvic Injuries

2
Chest Injuries

• There are two categories of chest injuries
  closed and open.
• All chest-injury victims should have their ABCs
  checked and rechecked.
• A responsive chest-injury victim should usually
  sit up or be placed with the injured side down.

3
Closed Chest Injuries

• In a closed chest injury, the skin is not broken.
• Closed chest injuries include rib fractures and
  flail chest.

4
Rib Fractures

• The upper four ribs are rarely fractured because
  they are protected by the collarbone and the
  shoulder blades.
• The lower two ribs are difficult to fracture
  because they are floating ribs.
• Broken ribs usually occur along the side of the
  chest.

5
Recognizing Rib Fractures

• Sharp pain when taking a deep breath, coughing,
  or moving
• Shallow breathing
• Trying to reduce the pain by holding the area

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

• A flail chest is a serious injury that involves
  several ribs in the same area broken in more than
  one place.
• This injury is very painful and makes breathing
  difficult.

8
Recognizing Flail Chest

• Paradoxical chest motion takes place
• Breathing very painful and difficult
• Bruising of the skin over the injury occurs

9
Care for Flail Chest

• Support the chest by one of several methods
• Apply hand pressure (useful for a short time).
• Place the victim on the injured side with a
  blanket underneath.
• Monitor breathing.
• Seek medical care.

10
Open Chest Injuries

• In an open chest injury, the skin has been broken
  and the chest wall is penetrated by an object,
  such as a knife or bullet.

11
Impaled Object in the Chest

• If an object penetrates the chest wall, air and
  blood escape into the space between the lungs and
  chest wall.
• The air and blood cause the lung to collapse.

12
Recognizing an Impaled Object in the Chest

• An impaled object is usually easily recognized
  however, in some cases the object may be below
  the skin surface.
• Carefully look at wounds that could be hiding the
  object that caused the damage.

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 9-1-1.

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 a chest wound during
  exhalation
• Sucking sound heard during inhalation

16
Care for a Sucking Chest Wound

• Seal open wound with plastic wrap.
• Tape on three sides.
• If victim has difficulty breathing, remove cover
  to let air escape, and reapply.
• Call 9-1-1.

17
Abdominal Injuries

• Abdominal injuries are either open or closed and
  can involve hollow and/or solid organs.
• An internal abdominal injury is one of the most
  frequently unrecognized injuries.
• When missed, it becomes one of the main causes of
  death.

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
• Bruising and damage to internal organs can result
  from a severe blow to the abdomen.

19
Recognizing a Closed Abdominal Injury

• Examine the abdomen by gently pressing all four
  quadrants of the abdomen with your fingertips.
• A normal abdomen is soft and not tender when
  pressed.
• Signs of a closed abdominal injury include
• Bruises and other marks
• Pain, tenderness, muscle tightness, or rigidity

20
Care for a Closed Abdominal Injury

• Place the victim on one side in a comfortable
  position with the legs slightly bent.
• Expect vomiting.
• Care for shock.
• Call 9-1-1.

21
Open Abdominal Injury

• Open abdominal injuries are those in which the
  skin has been broken.
• Also known as penetrating injuries
• Always assume the worstthat internal organs have
  been damaged.

22
Care for a Penetrating Wound

• If the penetrating object is still in place,
  stabilize the object and control the bleeding.
• Do not try to remove the object.
• Call 9-1-1.

23
Impaled Object

• Care is the same for an impaled object in the
  abdomen as for an impaled object in the chest.

24
Recognizing a Protruding Organ

• A protruding organ injury refers to a severe
  injury to the abdomen in which internal organs
  escape or protrude from the wound.

25
Care for Protruding Organs

• Call 9-1-1.
• Allow the victim to stay in a comfortable
  position.
• Cover the protruding organs with a moist sterile
  dressing.
• Treat for shock.

26
Pelvic Injuries

• Pelvic fractures are usually caused by falling or
  a motor vehicle crash.
• The signs of a pelvic injury include
• Pain in hip, groin, or back that increases with
  movement
• Inability to stand or walk
• Signs of shock

27
Care for Pelvic Injuries

• Treat the victim for shock.
• Place padding between the victims thighs, and
  tie the victims knees and ankles together.
• Keep the victim on a firm surface.
• Call 9-1-1.