Lesson 6: Chest Injuries Emergency Reference Guide p. 47-50

1. Lesson 6: Chest Injuries Emergency Reference Guide p. 47-50

2. Objectives • Demonstrate a field assessment of a person with a chest injury • Describe the emergency treatment and long term care of: • Fractured rib/clavicle • Pneumothorax • Tension pneumothorax • Fail Chest • Sucking Chest Wound • Describe when to evacuate SLOW vs. FAST

3. Checking and Caring for Chest Injuries • What are Signs & Symptoms of a Chest injury? • Deformity, Open wounds, Tenderness, Swelling (DOTS) • Windpipe pushed to one side of neck • Abnormal breathing • Bleeding or holes with/without bubbles, bruising • Unusual noises like gurgling or air escaping • Abnormal chest rise

4. Checking & Caring for Chest Injuries (cont’d.) • Signs & Symptoms (cont’d.) • Patient is guarding a particular area • While exerting some pressure with hands you • Hear cracking sounds • Feel/hear crumbling • Find depressions • Patient has point pain/tenderness along ribs or clavicle (aka collarbone)

5. Chest Injuries

6. Chest Injuries

7. Rib Injuries • What are the Signs & Symptoms? • Pain in the clavicle or rib area • Complaints of increased pain with deep breathing • Discoloration, bruising or swelling • Guarding the injury from being touched/moved • Specific point where pain is most intense

8. Rib Injury Treatment • Protect simple fracture by: • Supporting arm on injured side with sling & swath • DO NOT band snugly around patient’s chest • Encourage patient to take regular deep breaths to keep lungs clear of fluid • Try padding area to increase comfort

9. Rib Injury Care

10. Lung Injuries • Lung injuries can lead to pneumothorax (air trapped in chest). • Leads to: • Difficulty breathing & rising anxiety • Pneumothorax can worsen until patient cannot breath adequately (i.e. tension pneumothorax) • Suspicion of pneumothorax requires immediate (FAST) evacuation • No treatment available in wilderness setting for a lung injury

11. Flail Chest • Ribs broken in several places, free floating bones • Flail section moves in opposition to rest of chest • Not common, can be life-threatening, immediate evacuation necessary • May need to give rescue breaths • Applying bulky dressing may allow patient to breath easier. Do not wrap chest with tape

12. Sucking Chest Wound • Characterized by open wound that bubbles & makes noises when breathing • Do not remove impaled objects. Immobilize & seal wound(s) • Apply Occlusive dressing • Apply Air barrier (i.e. plastic baggie, etc.) • One corner is left open to allow air to escape

13. Guidelines for Evacuation • GO SLOW with suspected rib fracture. Patient may walk: • Must be evaluated by health care provider • Patient may have difficulty breathing • GO FAST & transport patient for: • Increase difficulty breathing • Flail chest • Sucking chest wound • Transport on side with injury or other position of comfort.

14. Preventing Chest Injuries • Prevention is important, since no effective field treatment is available in field

15. SHOUT OUT • What are some possible chest injuries you can anticipate in a Wilderness or remote location? • What are some smart ways to help prevent chest injuries?

16. Questions? What else can be added to the First Aid Kit?