Bandages on the chest

Chest wounds are one of the types of damage to the human body that can be encountered in accidents, accidents, falls, and blows.

You can also get such a wound when hit by cold or firearms. Injuries and wounds of this type are violations of the integrity of organs, bones, muscles, vessels in the chest.

As a result, a life-threatening condition arises, since broken bones, injured tissues or organs do not allow the body to normally and fully carry out both respiratory and other activities related to the work of the lungs, heart and blood vessels.

Signs and types of chest injuries

The main classification of such lesions is the division into penetrating and non-penetrating wounds. Penetrating refers to damage that affects the integrity of the pleura, while the internal tissues of the lungs and other organs in the chest may not be damaged. Chest wounds can also be penetrating, tangential, or blind. Through injuries are characterized by the presence of two holes – inlet and outlet, through which the injuring object penetrates into the tissues and then exits. Tangential wounds pass close to bones or organs without affecting them. Blind wounds are such a defeat in which the injuring object or part of it (bullet, fragments) remains in the wound.

Detection and differentiation of chest wounds do not cause difficulties, especially if they are open: wounds are characterized by pain, deterioration of respiratory function, limited mobility, swelling, bleeding and damage to the skin (open injuries). Bleeding can be venous, arterial or parenchymal, while the first two are extremely dangerous for a person, as they can very quickly cause large blood loss and death of the affected person. Serous-bloody contents can also be separated from the wound.

The most dangerous is the injury of the subclavian artery – with a wide wound, fatal bleeding occurs within a few minutes. If there is a blind or penetrating wound, this is complicated by the formation of a pulsating hematoma, which can threaten a person’s life for a long time.

A non-penetrating type of injury can be accompanied by extensive destruction of muscles and ligaments, as well as bone structures.

Why do you need bandages for chest injuries

Wounds and injuries of the chest are conditions that require medical attention. But now the ambulance has been called and is already rushing to help, and the victim with a massive wound and bleeding loses strength, loses blood and may not wait for specialized assistance.

First of all, it is necessary to assess the condition of the victim, and determine whether he has:

• closed;
• penetrating;
• non-penetrating injury.

The first type of lesion is the most difficult for the one who will provide first aid, since there is no external wound, but the injuries themselves can be mortal for a person. Closed chest wounds:

• rib fractures;
• shake;
• pneumothorax;
• hemothorax;
• traumatic asphyxia.

All these conditions can cause the development of heart or respiratory failure, however, a person without medical education, as well as without special tools and preparations, will not be able to take any global measures to help the victim. The first aid algorithm for closed chest wounds looks like this:

• call an ambulance;
• give the victim a semi-sitting position;
• gently and without sudden movements to release him from the constraining and interfering clothing;
• to an unconscious person throw his head back and slightly to one side;
• control consciousness and pulse until the arrival of doctors.

Non-penetrating wounds do not affect the integrity of the lungs, therefore they are considered less dangerous. After calling the doctors, it is necessary to assess the person’s condition, determine if he has bleeding, apply a pressure bandage and monitor his condition until the ambulance arrives.

Penetrating wounds greatly aggravate the patient’s condition. He has shortness of breath, a feeling of lack of air, bloody foamy sputum, a drop in blood pressure. A person should be in a semi-sitting state, he should not talk, breathe deeply, drink, eat. Be sure to apply a bandage.

Why is it necessary to bandage a patient with chest injuries? Typically, the application of a bandage has several purposes:

• immobilize the victim;
• stop the bleeding;
• prevent infection.

The difficulty of applying bandages to the chest is that the torso in this area has the shape of an inverted cone, in addition, it is constantly in rhythmic movement due to breathing, so the applied bandage can slip.

The most common dressing material for the chest is sterile medical bandages 10, 12 or 14 centimeters wide. Additional fasteners, solid elements for tires can also be used.

Rules for applying bandages for chest injuries

The location of the victim at the time of dressing should be such that it does not interfere with free access to the chest. Usually a person is left in a semi-sitting position, leaning his back or floor sideways to a hard surface so that he can breathe normally. When positioning the wounded, you should seat him so that the muscles in the affected area are as relaxed as possible. In case of fractures of the chest, spine or ribs, it is forbidden to change the position of the victim, except in exceptional cases, for example, if he needs to be pulled out of a burning car or from a rubble.

During bandaging, the damaged part should be motionless, a person should not inhale very deeply and exhale sharply. The person providing assistance, in the process of applying the bandage, is positioned so as to see both the injured chest and the face of the victim.

The first round (circular rim) of the bandage is fixing, and all subsequent rounds overlap each previous turn by two-thirds.

If there is heavy bleeding, it must be stopped using pressure bandaging techniques or finger pressure. Under the bandage, a sterile material is applied to the wound – gauze wipes, cotton pads or a clean cloth. The finished bandage should tightly fix not only the chest itself, but also the material placed under it. The edges of the wound should first be treated with antiseptic agents.

In cases where foreign bodies, bone fragments, fragments are present in the wound, it is forbidden to remove them independently. Foreign objects sticking out of the wound should be carefully wrapped around the perimeter with sterile wipes, fixed with tape, covered with sterile material and bandaged.

Types of dressings and dressings for the chest

Different types of wounds and injuries require different types of dressings. Each of them has a special application technique, some dressings require a certain level of medical knowledge. The main types of dressings for chest injuries:

• stellate or cruciform;
• spiral;
• hermetic;
• bandage according to the Deso method;
• bandage for mammary glands;
• ligation according to Velpo.

Star ligation

This type of dressing is one of the simplest used for chest injuries. For a cruciform or star bandage, you need a bandage 10 centimeters wide. During the dressing, the bandage is applied in eight-shaped moves.

Initially, the wound should be washed if it is of medium or shallow depth. It is forbidden to use running water or cauterizing drugs like iodine for this, you can use special antiseptics for these purposes. The skin around the wound should be treated with iodine or “green”.

A star-shaped or cruciform bandage begins to be applied from the bottom up. The first two or three rounds are done around the torso, they are fixing. Next, the bandage is sent to the area of ​​uXNUMXbuXNUMXbthe right armpit. After the bandage goes around the right shoulder joint, it is carried out under the right shoulder through the chest to the left armpit. The bandage bypasses the left shoulder joint and covers the top of the right shoulder. On the sternum, the dressing crosses, having an X-shaped appearance. The sequence of actions is repeated until the wound is completely closed and the chest is immobilized. The dressing ends with circular passages at the level below the sternum. If the star bandage is to cover a wound on the back, the application process will be similar, but should be done in reverse, so that the decussation is on the back.

This dressing, although easy to apply, is held rather weakly, so it should be resorted to only in extreme cases.

spiral bandage

It is used if the victim has chest injuries or pneumothorax (accumulation of air in the pleural part of the chest), it is also used for bruising of the chest. The width of the bandage required for it is about 10-12 centimeters. First, a piece is torn off from it, which is laid obliquely from the lower zone of the waist to the shoulder, and then also obliquely across the shoulder towards the abdomen, resulting in a V-shaped bandage overlay, or the so-called harness bandage. Circular moves are superimposed from bottom to top along the body – the first two or three for fixation, and then in a spiral the entire chest area is girded, gradually raising the bandage to the level of the armpits. Here the bandage must be fixed. The edges of the gauze piece, originally laid in the shape of the letter V, rise up and are tied at the shoulder. In this case, when spiral bandaging occurs, the bandage on one side passes below the V-shaped piece, on the other – above it. This section provides additional fastening for spiral bandages. If a strong fixation is required, the bandage can be stitched with threads.

Sealed or occlusive dressing

This type of dressing is used to prevent air from entering the pleural cavity with a penetrating wound of the chest. The tight bandage avoids contact of the pleural cavity with the surrounding air and environment, bacteria and other pathogens. A simple gauze or bandage is not suitable in this case – the dressing should not let air through. The best option is to use a dressing bag, and in its absence, non-sterile materials can be used, for example, plastic bags, films, oilcloth. The dressing bag is placed on the wound with a rubberized surface down, while gauze pads do not need to be placed under it. When using oilcloth non-sterile materials, a substrate of napkins is required – a material that does not allow air to pass must be placed on top. In both cases, a large lump of cotton wool should be placed on the bag or on napkins before bandaging, and only then carefully bandaged.

Fixation of an airtight dressing occurs in such a way as to provide coverage of the wound and immobilization of the chest. If the wound is located in the upper part of the sternum, bandaging can be done in a spike-like manner. Wounds below the third rib are covered with a spiral dressing.

Spica bandages are often applied to the area of ​​the shoulder joint. The bandage is carried out from the armpit of a healthy shoulder along the front of the chest, then it goes to the back and is removed through the other armpit forward. The bandage is carried around the shoulder, and is carried along the back from back to front. This tour of the bandage is laid in such a way as to half overlap the previous one on top, surrounding the chest. The bandage moves are carried out until the wound is completely covered, while the intersection of the bandage moves looks like a spikelet.

Desault method

Bandaging according to Dezo is performed with fixation of the hands to the body with a bandage. If the affected person has fractures of the ribs, collarbones, the Dezo bandage provides the possibility of immobilizing the limbs and preventing further trauma.

Before applying a bandage, a tight cotton roll wrapped in gauze is placed in the armpit. The arm must be bent at the elbow and pressed against the body. The first few moves of the bandage are fixing, they go in a circle.

Then the bandage goes from the healthy armpit through the sternum to the damaged area. The material is lowered behind the elbow and passed under it, covering the forearm. After that, the bandage is again sent to the area of ​​uXNUMXbuXNUMXba healthy armpit, from where it passes obliquely to the area above the collarbone, it falls along the shoulder and covers the elbow in front, and goes around the back and goes to the armpit. This bandaging is repeated several times until the bandage covers the affected area, tightly fixing the limb.

Ligation of the mammary glands

It is believed that this type of dressing is relevant for lactating women, however, these dressings can also be applied in cases where chest injuries affect the mammary glands in women. Bandaging is performed with a wide dressing material.

First, the bandage is fixed under the breast on the affected side. The material is drawn around the chest and rises obliquely from the base of the diseased area to the healthy area above the shoulder. The chest appears as if suspended on bandages. Next, bandaging occurs obliquely across the back, after which a circular motion is performed, with a bandage around the body.

The steps are repeated until the entire chest is bandaged. Each subsequent layer of material should cover the previous one by about half the width. The chest is fixed with hands so that when bandaging it takes the necessary position. Bandages should not be tightened, as this will lead to stagnation of blood. For the same reason, it is impossible to make circular moves in the nipple area.

Velpo bandage

It is used in cases where chest injuries are combined with shoulder dislocations. The dressing material is a bandage 10 centimeters wide. The patient’s arm must be bent at the elbow joint at an acute angle, the hand is placed on the forearm. A cotton-gauze tight roller is placed in the armpit. Initially, the tour of the bandage is carried out from the sore arm, bending around the shoulder and around the torso. The next round is carried out from the intact armpit to the diseased shoulder girdle, after which the bandage is laid from the front surface of the shoulder under the elbow joint, in front of the chest to the healthy side. The moves of the bandage material are repeated until the forearm and limb are completely immobilized.

Sling-like and kerchief types of dressings are practically not used for dressing the chest.

Treatment of fractures, bruises, inflammatory processes, dislocations, stopping bleeding in the chest area is difficult to imagine without the imposition of various types of dressings, and for each case a different kind of dressing can be used. The application of bandages can be both an element of first aid, and part of the treatment prescribed by the doctor after examining and diagnosing injuries.

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