Chest injuries, sternal and rib fractures: symptoms and first aid
Jun 07, 2018
The thorax is formed by the corresponding( thoracic) department of the spine and the ribs with cartilaginous extensions attached to each vertebrae.A person has only 12 pairs of ribs.Table of contents: Closed chest trauma Uncomplicated fractures of ribs and sternum Complicated rib fractures Penetrating chest injury
To thoracic injuries are:
- fractures of the sternum, ribs and spine;
- penetrating wounds;
Closed chest trauma
Most often, the chest contusion occurs during traffic accidents, in some cases - when playing sports or in a domestic setting.The doctor will see a swelling in the wound site and possibly a hemorrhage into the soft tissue during the examination of the patient.Immediately the victim will complain about pain of medium intensity, which will certainly increase during deep breathing or when traumatizing.If there is a bruise of the chest, it will be enough to apply cold to the place of injury( it can be not only a hot-water bottle with ice, but a bottle of cold water, pelmeni from the freezer - everything that is at hand).In the case of persistent pain, you can take any painkiller - for example, Pentalgin or Nurofen.Maximum after 3 days the pain subsides, and a week later, there will be no trace left of it.
A serious injury is considered to be chest compression, which can occur, for example, in the mountains( there was a stone crash) or in a traffic accident( the car is badly damaged and presses on the injured person).At the time of injury, air that is in the lungs is compressed, and therefore there are small ruptures of lung tissue, airways and blood vessels.The result is small hemorrhages on the face and skin of the upper body, in some cases there is a cough with phlegm.When the chest is squeezed, the victim will complain of moderate pain in the chest, tinnitus, a hoarse voice( he may not be at all), impaired hearing and vision.In especially severe cases, the victim may be disturbed by consciousness.
First aid for chest compression is to release the victim.Further all rescue activities should be carried out by doctors, therefore it is important to deliver the victim as soon as possible to the medical institution.
Uncomplicated fractures of ribs and sternum
In the case of such injuries, only bone fragments, vessels and pleura are damaged, but lung tissue does not suffer.
Ridge fracture is accompanied by intense pain in the chest with breathing, coughing and any, even minimal, movement.This pain is much stronger than with a bruised chest - the victim can literally scream.When examining the patient from behind, it will be clearly seen that the affected half of the chest lags behind in the breath from the healthy one.In the case of multiple fractures of the ribs, the victim's breathing will become rapid and superficial.A characteristic feature of fracture of the ribs - a person with such a trauma will involuntarily press his hand to the site of the injury, thereby limiting the movement of the broken rib.
First aid does not imply the imposition of a tight bandage - it will only increase the pain and make breathing more difficult.The patient needs to create a rest and then the pain will cease, you can take painkillers.It is highly desirable to visit a medical institution to undergo an examination with a specialist and make sure that a really uncomplicated injury of the ribs has occurred.
A sternal fracture can occur with a direct stroke in the front of the chest.Such a trauma is characterized by severe pain during breathing and palpation.Immediately after the fracture, two fragments are identified, displaced relative to each other.After some time, the victim rapidly swelling of the chest, there is a hemorrhage in the place of injury.
First aid for a fracture of the sternum is laying the victim on a hard shield in the position on the back, admitting pain medication.The obligatory moment is the delivery of the injured to the medical institution - the specialists will conduct a professional examination of the patient, which will exclude damage to the heart, including a traumatic heart attack.
Complicated fractures of theribs
Such injuries are severe, characterized by a displacement of bone fragments inward, damage to the pleura and lungs. Symptoms of a complicated fracture of the ribs are:
- intense pain syndrome in the place of injury;
- sensation of lack of air, inability to make a full breath and exhale, shortness of breath;
- cyanosis of the lips;
- cough with sputum, which contains elements of blood;
- pallor of the skin;
- frequent pulse;
- surface respiration.
The victim will take a sitting position - so it's much easier for him to breathe, and the pain is not so intense.
During the trauma of the injury site, a characteristic cracking is detected, which is a sign of damage to the outer pleura( pneumothorax).The result of such damage is the ingress of air into the pleural cavity and the collapse of the lung.Often in the cavity of the pleura accumulates blood, and then the doctors will diagnose hemothorax.
The most dangerous are the final fractures, which most often occur when you hit the steering wheel during a road accident.The final fracture is characterized by the presence of two fractures on each rib - a movable area is formed which, during breathing, shifts and permanently damages the lungs( with each inhalation / expiration).The victim with the final fracture of the ribs can not breathe in, as he immediately suffocates. The signs of such a fracture are:
- swelling of the cervical veins;
- is a swelling of the chest( an accumulation of air under the skin), which swiftly spreads to the face, neck, abdomen and lower limbs.
First aid for complicated fractures of the ribs is to release the victim from compression.Further activities should be carried out by an expert, so the patient is urgently transported to a medical facility.
Penetrating chest injury
Such a trauma is considered extremely dangerous: an open pneumothorax develops, which keeps a constant supply of air from the environment into the pleural cavity.The accumulating air presses more and more on the lung and its collapse occurs.When the pneumothorax is open, sloshing, gurgling and smacking sounds are distinctly heard in the wound area, and with exhalation foamy blood is released from the wound hole.
First aid for open pneumothorax consists in sealing the wound and stopping the entry of air into it.The simplest thing is to quickly cover the wound with the palm of your hand, but then you will need to place several large pieces of tissue on the wound( these can be ordinary handkerchiefs) and cover with airtight material from above.As the latter, several layers of adhesive plaster, an oilcloth or a plastic bag can be used.It will be necessary to fix all the superimposed material on the wound, and it can be done with a bandage or any cloth, wrapping it around the chest.Further, qualified medical care will be required, so the victim should be urgently delivered to a medical institution or called an ambulance brigade.If it is necessary to transport a person with an open pneumothorax on their own, then it is worth remembering the basic rule of transportation of such patients: a person should be in a semi-sitting position, knees in a semi-bent position, and a roller( blanket, clothing) must be placed under them.
Chest injuries, rib fractures are serious enough conditions that must necessarily be under the control of medical workers.Timely first aid with penetrating sternum wounds and complicated rib fractures can not only significantly alleviate the condition of the victim, but also save his life( for example, with open pneumothorax).
Tsygankova Yana Aleksandrovna, medical reviewer, therapeutist of the highest qualification category