Chapter 13Chest, Abdominal, and

Pelvic Injuries

Chest Injuries

• Open or closed• All people with chest injuries should have

airway, breathing, and circulation checked and rechecked.

• A responsive person should sit up or be placed with injured side down.

Closed Chest Injuries

• In a closed chest injury, the skin is not broken.

Rib Fractures

• The upper four ribs are protected by muscles, collarbone, and shoulder blades.

• The lower two ribs, “floating ribs,” have freedom to move.

• Broken ribs usually occur along the side of the chest.

Rib Fractures: What to Look For

• Sharp pain when person takes deep breaths, coughs, or moves

• Guarding• Tenderness• Shallow breathing• Bruising of skin over injury

Rib Fractures: What to Do

• Help person find a comfortable position.

• Stabilize chest.• Give pain medication.• Have person take very

deep, slow breaths.• Call 9-1-1.

© American Academy of Orthopaedic Surgeons.

© American Academy of Orthopaedic Surgeons.

Flail Chest: What to Look For

• Paradoxical chest motion• Very painful and difficult breathing• Bruising of skin over the injury• Same signs as for rib fractures

Flail Chest: What to Do

• Do not apply constrictive bandages around the chest.

• Call 9-1-1.

Open Chest Injuries

• An open chest injury is when the skin has been broken and the chest wall is penetrated.

Sucking Chest Wound

• What to look for− Blood bubbling out of chest wound − Sucking sound during inhalation

• What to do− Leave the wound exposed to air.− Do not cover unless using direct pressure and

a dry gauze dressing to control bleeding.− Call 9-1-1.

Impaled Object in the Chest

• What to look for− Usually easily

recognized• What to do

− Stabilize the object in place with bulky dressings.

− Call 9-1-1.© American Academy of Orthopaedic Surgeons.

Abdominal Injuries

• Abdominal injuries are either open or closed and can involve hollow and/or solid organs.− Hollow organ rupture spills contents of organ

into abdomen.− Solid organ rupture results in internal

bleeding.

Closed Abdominal Injury

• Occur when the internal abdominal tissues are damaged but the skin is unbroken

• Examine by gently pressing all four quadrants.

© Jones & Bartlett Learning.

Closed Abdominal Injury

• What to look for− Bruises or other marks− Pain, tenderness, muscle tightness, or rigidity− Distention

• What to do− If unresponsive, place in recovery position.− If responsive, place in side-lying position.− Call 9-1-1.

Open Abdominal Injury

• Open abdominal injuries are those in which the skin has been broken.− Also called penetrating injuries

• Stab wounds• Gunshot wounds

Penetrating Injury: What to Do

• Stabilize object against movement and control bleeding by placing bulky dressings around it.

• Call 9-1-1.

© Jones & Bartlett Learning. Courtesy of MIEMSS. © Jones & Bartlett Learning. Courtesy of MIEMSS.

Protruding Organs: What to Do

• Have person stay in comfortable position with legs pulled toward abdomen.

• Cover organs with a moist, clean dressing.• Call 9-1-1.

© Jones & Bartlett Learning. Courtesy of MIEMSS.

Pelvic Injuries

• Pelvic fractures are usually caused by falling or a motor vehicle crash.

• Check pelvis by gently pressing inward and downward on the tops of the hips.− If pain results, suspect a fracture.

Pelvic Injuries: What to Look For

• Pain in the hip, groin, or back that increases with movement

• Inability to stand or walk• Signs of shock

Pelvic Injuries: What to Do

• Call 9-1-1.• Do not move person.• Keep person lying flat.• Treat for shock.