1. Chest, Abdominal, and Pelvic Injuries
Chapter 13
Chest, Abdominal, and
Pelvic Injuries 1

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

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

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

21. Open Abdominal Injury
Open abdominal injuries are those in which the skin has been broken.
Also known as penetrating injuries
Always assume the worst—that 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

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
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 victim’s thighs, and tie the victim’s knees and ankles together.
Keep the victim on a firm surface.
Call