Chapter 13 Chest, Abdominal, and Pelvic Injuries
Transcript of Chapter 13 Chest, Abdominal, and Pelvic Injuries
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Chapter 13Chest, Abdominal, and
Pelvic Injuries
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Chest Injuries
• Open or closed• All victims should have their airway,
breathing, and circulation checked.• A responsive victim should sit up or
be placed with injured side down.
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Closed Chest Injuries
In a closed chest injury, the skin is not broken.
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Rib Fractures
• The upper four ribs are protected by the collarbone and shoulder blades.
• The lower two ribs, “floating ribs,” have freedom to move.
• Broken ribs usually occur along the side of the chest.
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Recognizing Rib Fractures• Sharp pain (deep breath, coughing, or moving)• Victim holds injured area. • Victim reports being hit where there is pain. • Area is tender. • Shallow breathing Gently press inward on both sides of the chest at the same time to assess for a rib fracture.
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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.
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Flail Chest• Flail chest involves several ribs in the
same area broken in more than one place.
• Paradoxical movement is when the area over the injury moves in a direction opposite to that of the rest of the chest wall during breathing.
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Recognizing Flail Chest• Paradoxical chest motion
takes place.• Breathing is very painful
and difficult.• Bruising may occur.
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Care for Flail Chest• Support the chest.
• Apply hand pressure.• Place victim on injured side with blanket
underneath.• Monitor breathing.• Seek medical care.
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Open Chest Injuries
An open chest injury is when the skin has been broken and the chest wall is penetrated.
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Impaled Object in the Chest
An impaled object penetrates the chest wall. • Causes air and blood to escape into the space
between lungs and chest wall • Lung collapses.• Can lead to shock and death
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Recognizing an Impaled Object in the Chest
• Usually easy to see • Object may be below skin surface.• Look for hidden objects.
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Care for an Impaled Object in the Chest
• Stabilize the object in place with bulky dressings.
• Do not try to remove the object.
• Call 9-1-1.
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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.
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Recognizing a Sucking Chest Wound
• Blood bubbling out of chest wound during exhalation
• Sucking sound during inhalation
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Care for a Sucking Chest Wound• Seal the wound.
• Plastic wrap or plastic bag• Tape plastic in place; leave one side open.• Drain to gravity.
• Lean or lay victim on injured side.• Remove plastic if victim has trouble
breathing or seems to be getting worse.• Call 9-1-1.
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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.
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Closed Abdominal Injury• Closed abdominal injuries occur when
the internal abdominal tissues are damaged but the skin is unbroken.• Also known as blunt injuries
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Recognizing a Closed Abdominal Injury
• Gently press all four quadrants of the abdomen.
• Notice:• Bruises or marks• Pain, tenderness,
muscle tightness, or rigidity
• Distention (swelling)
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Care for a Closed Abdominal InjuryUnresponsive:• Place victim on left
side in comfortable position with legs bent (“fetal position”).
• Call 9-1-1.
Responsive:• Place victim on one
side in comfortable position with legs slightly bent.
• Call 9-1-1.
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Open Abdominal Injury• Open abdominal injuries are those in
which the skin has been broken. • Also known as penetrating injuries
• Always serious • Usually cause internal organ damage
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Care for a Penetrating Wound
• Stabilize the penetrating object.
• Place bulky dressings around object.
• Do not try to remove object. • Call 9-1-1.
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Protruding Organs• Also called an evisceration• Severe injury in which internal
organs escape or protrude from wound
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Care for Protruding Organs• Call 9-1-1.• Allow victim to stay
in comfortable position.• Legs pulled toward
abdomen• Cover protruding
organs.• Treat for shock.
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Pelvic Injuries
Pelvic fractures are usually caused by falling or a motor vehicle crash.
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Recognizing Pelvic Injuries• Pain in hip, groin, or back
• Increases with movement• Inability to stand or walk • Signs of shock• Check pelvis by gently pressing inward
and downward on tops of hips.
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Care for Pelvic Injuries
• Treat the victim for shock.• Place padding between victim’s
thighs.• Tie victim’s knees and ankles
together.• Keep victim on a firm surface.• Call 9-1-1.