Often, injuries and various kinds of injuries of the thoracic region mean a fracture of the ribs, in addition, the most important organs of the human body (heart, lungs, main blood vessels) are injured. When providing first aid to the victim, do not forget to determine if there are respiratory disorders that are extremely life-threatening. It is this consequence that is most characteristic of the type of injury in question.
Consequences
There are several of the most dangerous consequences of chest injuries:
- Pneumothorax (accumulation of large amounts of air in the pleural cavity).
- Hemothorax (blood entering the pleural cavity).
- Emphysema of the mediastinum (begins to put pressure on large veins).
- Traumatic suffocation.
- Contusion of the heart.
- Cardiac tamponade (accumulation of blood in the pericardium as a result of damage to the fragments of the ribs).
Types of injury
Types of damage:
- thoracic injuries (injuries can be open or closed);
- lung injury;
- injuries characterized by increasedcomplexity (this may be a rupture of the bronchi or diaphragm, a violation of the function of the heart muscle).
These types of chest wounds can be inflicted with a knife or other weapon. Knife wounds often occur during fights and various domestic quarrels, stab wounds can also occur through negligence and during road accidents, emergencies and various natural and man-made disasters.
Wounds received by a person from firearms mainly occur during military operations, demonstrations, pickets, as well as during fights, shootings and quarrels. These wounds can be inflicted on the human body by a bullet, automatic or machine-gun fire, shrapnel or shot. And also during the explosion of mines, grenades and the use of explosive cluster shells.
Depending on the weapon used, they are divided into penetrating, blind and tangential wounds. The first wounds have two holes - into which the damaging object entered, and the second hole, from where this object came out. The second type of wound has only an inlet, no outlet.
Characteristics of wounds
Wounds of the chest can be applied tangentially, then only soft tissues are damaged. With a penetrating wound, the bones of the chest can be broken, the area around the lungs is disturbed, and the lungs are damaged. As a result of a wound inflicted by a knife, the integrity of the soft tissues is mainly destroyed and the vessels are damaged, the bones remain intact. If the wound is received after the use of any of the types of weapons, not only softtissues and blood vessels, but bones break, and broken bones, under the force of a shot, break and tear the internal organs and bones of the chest.
Stab wounds
Wounds caused by sharp piercing and cutting objects are accompanied by the following damage to organs, soft tissues and blood vessels. In many cases, a penetrating wound damages the lungs, causing air to enter or bleeding to occur.
Bleeding can be caused by ruptured internal intercostal and other arteries that are in the chest. As a result of this bleeding, a person's respiratory function and heart function worsen. In the event that air has entered the lungs, but there is no bleeding, all necessary medical methods must be taken. After a few days, the air will be able to leave the lungs.
Heart injury
In addition to soft tissues, arteries and blood vessels, wounds can affect both the lining of the heart and the organ itself. This injury is very serious, as it can lead to a stop of this organ, as a result of which a person dies.
Basically, as a result of injury to an organ such as the heart, the atria or ventricles are damaged, in rare cases only the shell of the organ is damaged. The wound is very dangerous due to bleeding in the form of a fountain, as well as blood filling nearby organs.
Gunshot wounds
In case of a gunshot wound of the chest, the damage is more serious, as it entails rupture of tissues, tendons, bones, blood vessels andarteries. In addition to the charging substance itself, which gets into the wound, pieces of clothing and other foreign objects are also involved in it. With such an injury, in addition to the organs that are in the chest, organs located in the abdominal region of the human body can also be damaged.
The locality of the wound depends on the type of weapon used, the angle and distance from which the shot is fired. If the shot is fired from above, the bullet can enter the stomach through the respiratory tract. Depending on the power and caliber of bullets or shells in the body, the liver, kidneys and other internal organs can also be damaged.
Because breathing is disturbed, a person feels bad due to lack of oxygen in the blood. In addition, there is pain, a violation of the heartbeat. Blood comes out of the wound, as if filled with oxygen, in the form of foam. This means that the lungs are damaged, and the wounded may also show blood in saliva. Or bleeding from the oral cavity and at the same time from the wound. In the case of a heart injury, a person has an altered complexion, sweating increases on the body. People with this type of injury are in shock, often unconscious in the hospital. When checking the pulse, the result is barely perceptible. In the case of a bullet wound, blood pressure is greatly reduced.
Visually, if the heart is damaged, an enlarged area can be seen on the chest near the heart. If during the shot the bullet hit the liver, blood vessels or spleen, the blood from these organs fills all the empty space and all organs inside the abdominal partbody.
Symptoms
The chest, despite its rigid structure, is more likely to be injured than any other part of the skeleton. A careless fall, a sharp blow, an illness or an emergency are quite capable of violating the integrity of the costal arch and sternum, leading to multiple problems with the respiratory and cardiovascular systems.
In order to diagnose the onset of serious failures, you need to know the symptoms of damage to the walls of the sternum:
- Pain syndrome that occurs every time you take a deep breath or exhale.
- Cough chest and very strong, whistling sound.
- Hematospitting. If there is internal bleeding and inflammation of the internal organs, the cough is quickly supplemented by sputum mixed with blood.
- Deformation of the bone corset. If there was a fracture of the vaults.
- Development of pneumothorax - that is, excessive accumulation of air in the pleural cavity. Its signs are gurgling, whistling, hoarse tones when inhaling or exhaling. The main danger of this condition is the development of acute respiratory failure, asphyxia, atony.
- Increase in body temperature to 38-39 degrees.
- Fever.
- Pulmonary edema. Manifested by the appearance of white foam around the mouth, combined with impaired respiratory function, palpitations, a decrease or a sharp rise in blood pressure, dizziness, weakness, nausea.
First Aid
It turns out that she is both on the spot and urgently in the nearest medical facility. First aid for a penetrating wound of the chest should be provided on the spot, if this is not done, medical care will already be useless. This is in case of damage to the lung, when the right amount of oxygen does not enter the body. It is urgent to apply a cotton or gauze swab to the wound, smearing it with something greasy so that air does not enter the wound. Then you need to put a piece of polyethylene and a bandage on top.
In case of any kind of injury, the patient urgently needs to be taken to the nearest medical institution.
Saving lives
First aid for a penetrating chest wound is to give the patient pain medication as these injuries are quite painful. You can use metamizole sodium, ketorolac, tramadol at a dosage of 1-2 ml. And only medical workers in exceptional cases can give the victim a narcotic analgesic, for example, a 1% solution of promedol. You also need to find something to treat an open wound (hydrogen peroxide, iodine, brilliant green).
When the ribs are broken, the first thing to do is to apply a fixing hermetic bandage. If there are wounds, they must be treated, then cellophane is applied to the damaged area and only after that a fixing bandage.
When a contusion of the heart, accompanied by pain in the chest, low blood pressure and heart palpitations, medications are used to block pain. As a rule, they are administered intravenously. Transportation of victims is possible only inlying position with a slightly raised upper body on a stretcher. With cardiac tamponade, transportation is carried out in a semi-sitting position using a stretcher. Without exception, all victims with chest injuries need urgent medical intervention. For this, the patient is taken to the nearest surgical department, where doctors stop the bleeding, and also use pain-relieving drugs and funds to support heart function. Additionally, oxygen inhalations are used.
In case of cardiac tamponade, a pericardial puncture should be done. From the needle, which pierced the pericardium, blood begins to flow continuously. It is not removed until the patient is taken to the hospital, where doctors will completely stop the bleeding. Also, with the development of valvular pneumothorax, the doctor pierces the pleural cavity with a needle, after which he removes the air and blood accumulated there.
How to transport with a chest wound?
Transportation of the victim should be carried out, observing certain rules regarding the position in which he is. Thus, the escort must pay particular attention to the posture in which the casu alty is transported. Help should be given to bring him to a semi-sitting position with bent knees. Having brought the victim into this position, it is necessary to place a roller under him. Transportation must also be carried out in accordance with the following principles:
- efficiency;
- safety - requires ensuring the patency of the respiratory tract of the victim, ensuring gas exchange, as well asavailability of access to the respiratory channel;
- gentle attitude - it is not allowed to cause pain to the injured person by not following the conditions of transportation, as this can lead to a state of shock.
The probability of saving the life of the wounded directly depends on the success of the transportation, in particular, on the position occupied. Thus, adherence to the principles of transportation is one of the most important points in providing first aid for wounds in the chest area.
Treatment
Necessary primary medical care - find how to treat an open wound, apply a bandage with a thick layer of sterile cotton sheathed with a bandage, the edges should be several centimeters larger than the diameter of the damage. Stopping the flow of air into the tissues with a special patch will also help.
Before transporting the wounded, painkillers should be administered:
- morphine;
- pantopon etc.
In case of bullet wounds, shattered parts or severe bruises should be removed surgically. This will help prevent sepsis and further tissue decay.
Treatment of bruises
In case of severe bruising of the chest, it is necessary to provide the patient with free access to oxygen, to introduce an anesthetic blockade. Regardless of the type of chest injury, an x-ray is required to fully understand the extent of the injury.
Only after that further treatment is prescribed and a decision is made about whethersurgical intervention. With a mechanical concussion of the chest, the victim goes into shock and has problems with spontaneous breathing. In this case, it is required to organize the supply of air artificially.
Open Wound Treatment
In case of open, lacerated injuries, it is necessary to stop the bleeding. Also, with injuries of this nature, suturing cannot be dispensed with. If the ribs are fractured, the victim's body movements should be limited until the ambulance arrives, as the bone can touch the heart, blood vessels or lungs, which will lead to more serious consequences, such as hemorrhage. In the hospital, the ribs will be fixed in the correct position using a special corset. X-rays should not be neglected, as they can reveal the presence of fragments that need to be removed surgically. During the healing process (from 4 to 7 weeks), painkillers are used, for example, Novocain.
When the lungs are injured, it is first necessary to apply a tight bandage during exhalation. Do not allow the victim to lose consciousness from loss of blood, as this can even lead to death. Further, the wounded person needs artificial respiration, taking measures to treat soft tissues with antiseptic agents to prevent infection and suturing. Later, when the lungs are injured, regular dressings are first of all necessary to avoid the appearance of purulent wounds.
