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The chest is a cavity bounded by muscles, ligaments, and ribs, which form the actual “cage”. In this space there are internal organs that are responsible for performing the most important functions of the body – breathing, carrying food into the stomach, oxygen and blood metabolism. That is why wounds and injuries of the chest are considered one of the most dangerous of all possible. They can affect internal organs, the vascular system, bones, soft tissues, and skin. And due to the fact that damage threatens the integrity of the heart and lungs – vital organs – a person with a chest injury must be hospitalized without fail, and until the ambulance team arrives, he needs to be given first aid if possible .
Chest wounds: what is it and what are
The concept of “injuries/wounds of the chest” includes a group of injuries of a diverse nature that affect any elements located in the sternum – organs, bones, tissues, blood vessels. In the absence of medical care, such injuries have a high percentage of the likelihood of death, however, if the victim is delivered to a medical facility in a timely manner, he will have a great chance of surviving.
All injuries in this area of the body are divided, first of all, into open and closed ones. It is closed wounds and injuries that pose a significant danger to humans. Their distinctive feature is that the integrity of the skin is not violated, while a life-threatening pathology can form under the skin. It is impossible to detect it during a visual examination, and it will be very difficult for a person without the appropriate medical qualification to identify a closed wound, and, therefore, to provide adequate first aid.
Open injuries are visible to the naked eye – the skin can be cut, torn, chopped or crushed, and through the holes in it, you can see internal injuries, bleeding, tears and fractures.
The number of closed chest wounds in peacetime prevails over the statistics of open injuries. People receive closed defeats during car accidents, falls from heights, plane crashes, fights and blows. Open injuries, most often, appear as a result of receiving gunshot or stab wounds.
In addition, injuries are classified according to the type of penetration into the body – they can be deep and superficial, tangential and through.
The main classification of chest injuries implies their division in this way – closed injuries are represented by bruises, compression, concussions.
Open, in turn, are divided into:
- penetrating;
- non-penetrating;
- wounds with bone damage;
- with damage to internal organs;
- with open pneumothorax or hemothorax;
- with simultaneous violation of the integrity of the sternum, diaphragm and abdominal cavity (thoracoabdominal wounds).
General characteristics of the main types of damage
Bruises, compression and concussion of the chest occur due to strong blows with a blunt heavy object, or a sharp compression of the sternum between several hard objects. A bruise is a violation of the structure and vital activity of soft tissues. In a weak degree, it practically does not pose a threat to humans. Severe bruises can cause internal hemorrhages with ruptures of tissues and organs. Concussion is accompanied by a severe form of shock in the absence of anatomical disorders. Breathing, circulation and pulse are disturbed. Compression of the chest causes suffocation, shortness of breath, impaired consciousness.
Open wounds are divided into penetrating and non-penetrating. The first type is more dangerous, as it is associated with a violation of the integrity of the pleural cavity of the lungs. Non-penetrating injuries do not involve the pleural cavity.
Hemothorax is an accumulation of blood in the pleural cavity of the lungs. The pathological condition is formed due to damage to the intercostal vessels. Pneumothorax refers to the accumulation of air in the pleural cavity – it gets there from a damaged lung or from the environment.
Providing first aid to a victim who is suspected or diagnosed with a chest injury can only be adequate if the person providing it has a basic level of medical training, for example, has completed first aid courses, and also has enough knowledge and skills to differentiate different types of injuries. Otherwise, there is a high probability of causing even more harm to a person.
Rules for first aid for chest injuries
First of all, first aid to the victim begins with the study of his condition. In the presence of any type of wounds and injuries of the sternum, a person should not talk, therefore, to determine the severity of his injuries, the one who provides first aid should focus on the following signs:
- expectoration of blood;
- subcutaneous emphysema;
- no breath sound
- sternum deformity;
- atypical mobility of the chest;
- changes in heart rate, blood pressure, skin color.
In case of a bruise, the patient must be given a semi-sitting position, free the chest from clothing, ensure the conduction of the respiratory tract – the mouth and nose must be opened, and the oral cavity and nasopharynx should be cleaned of mucus, vomit, and blood. This can be done with a finger wrapped in gauze. If the victim vomits, his head should be tilted to the side. To prevent the tongue from sinking, the person’s head is thrown back, the lower jaw is pushed forward, thus opening the mouth. The tongue is pulled out, pierced with a pin, pinned to the skin on the chin. If the manipulations did not help to restore breathing, you need to start artificial respiration. If the patient is breathing, an oxygen bag may be offered.
Multiple fractures of the ribs are accompanied by severe pain when inhaling. It is necessary to ensure complete immobilization of the damaged area. To do this, a bandage is applied to the chest – a bandage, from a towel, sheets, or any clean material. The victim is transported to the hospital in a semi-sitting position.
In the presence of a non-penetrating open wound, the patient may have a slight bleeding – in this case, the edges of the wound around the circumference are treated with iodine, alcohol or greenery, and a bandage is applied over it. Large, profuse bleeding requires the imposition of a pressure bandage.
Closed pneumothorax – a condition in which the edges of the wound, where air has entered, quickly close. The wound is treated with an antiseptic in a circle, covered with a sterile gauze napkin, which is fixed with a plaster. Next, a bandage is applied to the sternum. The patient is placed in a semi-sitting position, an ice pack or a bottle of cold water is applied to the chest.
A penetrating wound is characterized by trauma to the lung tissue, the patient has hemorrhage. One of the symptoms of such damage is a whistling sound that is heard when inhaling and exhaling. The general condition of such a victim is assessed as serious.
First of all, it is necessary to close the wound of the chest cavity. Its edges are treated with iodine, and then the wound is closed with a sterile napkin, on top of which a plastic film is placed. The napkin is fixed with a plaster, bandaged over it with a wide bandage, sheet, towel.
If the wound is in the region of the heart, the heart is considered to be affected for first aid purposes. The edges of the wound are disinfected, it is covered with a sterile bandage. Foreign bodies must not be removed from the wound. The patient is transported on a stretcher, placing him with a raised head end of the torso.
Minor closed injuries, such as bruises, can be treated with cold, pain medication, but they still require medical attention and medical attention.
Victims who have trauma to the sternum must be hospitalized in a medical facility. However, until the moment the patient falls into the hands of qualified doctors, his life must be supported by providing him with first aid in accordance with the rules for each specific lesion. It is extremely important to correctly determine what kind of injury is present in a particular person – penetrating or non-penetrating, with or without hemothorax and pneumothorax, with or without damage to internal organs.
First aid for chest injuries is a factor that determines how great the chances of the victim to survive are.