Often, injuries and various kinds of injuries of the thoracic region mean fracture of the ribs, in addition, the most important organs of the human body (heart, lungs, main blood vessels) are injured. When giving first aid to the victim, do not forget to determine if there are respiratory disorders that are extremely dangerous for a person's life. It is this consequence that is most characteristic of the type of injury under consideration.
Effects
There are several of the most dangerous consequences of chest injuries:
- Pneumothorax (accumulation of a large amount of air in the pleural cavity).
- Hemothorax (blood entering the pleural cavity).
- Mediastinal emphysema (begins to press on large veins).
- Traumatic asphyxiation.
- Heart injury.
- Cardiac tamponade (accumulation of blood in the pericardium as a result of its damage by fragments of the ribs).
Types of injuries
Varieties of damage:
- thoracic injuries (lesions can be open and closed);
- lung damage;
- injuries characterized by increased complexity (this can be a rupture of the bronchi or diaphragm, impaired function of the heart muscle).
These types of chest injuries can be inflicted with a knife or other weapon. Knife wounds often occur during fights and various domestic quarrels, stab wounds can also occur due to negligence and during accidents, emergencies and various natural and man-made disasters.
The wounds received by a person from a firearm mainly arise during military operations, demonstrations, pickets, as well as during fights, skirmishes and quarrels. These injuries can be inflicted on the human body by a bullet, machine gun or machine gun burst, fragment or shot. And also during the bursting of mines, grenades and the use of explosive cluster shells.
Depending on the weapon used, they are divided into through, blind and tangent wounds. The first wounds have two holes - into which the damaging item entered, and a second hole from where this item came out. The second type of injury has only an inlet, no outlet.
Characterization of injuries
Chest injuries 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 broken, the lungs are damaged. As a result of a wound inflicted by a knife, the integrity of soft tissues is mainly destroyed and blood vessels are damaged, the bones remain intact. If a wound is received after using any of the weapons, not only the soft tissues and blood vessels are destroyed, but the bones break, and the broken bones, under the force of a shot, break and tear the internal organs and bones of the chest.
Knife wounds
Injuries caused by sharp stabbing and cutting objects are accompanied by the following damage to organs, soft tissues and blood vessels. In many cases, penetrating wounds damage the lungs, as a result of which air gets into them or bleeding opens.
The cause of bleeding can be torn internal intercostal and other arteries that are in the chest. As a result of this bleeding, a person's respiratory function and heart function deteriorate. In the event that air gets into the lungs, but there is no bleeding, you need to take all the necessary medical methods. After a few days, air can exit the lungs.
Heart wound
In addition to soft tissues, arteries and blood vessels, a wound can affect both the lining of the heart and the organ itself. This wound 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 injuring an organ such as the heart, the atrium or ventricles are damaged, in rare cases only the membrane of the organ is damaged. Injury is very dangerous due to bleeding in the form of a fountain, and blood also fills nearby organs.
Gunshot wounds
With a gunshot wound to the chest, the damage is more serious, since it entails a rupture of tissues, tendons, bones, blood vessels and arteries. In addition to the charging substance that gets into the wound, pieces of clothing and other foreign objects are also involved in it. With such a wound, in addition to the organs that are in the chest, organs located in the abdominal part 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 airways. Depending on the power and caliber of bullets or shells in the body, the liver, kidneys and other internal organs can also be damaged.
Since breathing is disturbed, a person feels bad due to a 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 person may also show blood in the saliva. Or bleeding from the mouth and simultaneously from the wound. In case of heart injury, a person has a changed complexion, sweating increases on the body. People with this type of injury are in shock, often they go to the hospital unconscious. When checking the pulse, the result is hardly noticeable. In the case of a bullet wound, the arterial pressure is greatly reduced.
Visually, with heart damage, an enlarged area can be seen on the chest in the region of the heart. If during a shot a bullet hits the liver, blood vessels or spleen, blood from these organs fills all the empty space and all organs inside the abdominal part of the body.
Symptoms
The chest, despite its rigid structure, is more likely to be traumatized than any other part of the bone skeleton. A careless fall, a sharp blow, a disease or an emergency is quite capable of violating the integrity of the costal arch and sternum, leading to the occurrence of multiple problems with the respiratory, cardiovascular system.
In order to diagnose the beginning of serious failures, you need to know the symptoms of damage to the walls of the sternum:
- Pain syndrome that occurs each time with a deep breath or exhale.
- Coughing chest and very strong, with a whistling sound.
- Hemoptysis. If there is internal bleeding and inflammation of the internal organs, the cough is quickly supplemented with sputum mixed with blood.
- Deformation of the bone corset. If there was a fracture of the arches.
- The development of pneumatics - that is, excessive accumulation of air in the pleural cavity. Its signs are gurgling, wheezing, 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. It manifests itself by the appearance of white foam near the mouth in combination with impaired respiratory function, rapid heartbeat, decreased or sharp rise in blood pressure, dizziness, weakness, nausea.
First aid
She appears both on the spot and urgently in the nearest medical facility. First aid for penetrating wounds of the chest must be provided on the spot, if this is not done, medical care will already be useless. This is in case of lung damage, when the right amount of oxygen does not enter the body. An urgent need to put a cotton or gauze swab on the wound site, smearing with something greasy so that the air does not enter the wound. Then from above it is necessary to put a piece of polyethylene and a bandage.
For any type of injury, the patient urgently needs to be delivered to the nearest medical treatment institution.
Life saving
First aid for penetrating wounds of the chest is to give the patient an analgesic, since such injuries are rather painful. You can apply metamizole sodium, ketorolac, tramadol in 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. It is also necessary to find how to treat an open wound (hydrogen peroxide, iodine, brilliant green).
In case of fracture of the ribs, the first thing to do is to apply a tight, tight bandage. If there are wounds, they should be treated, then cellophane is applied to the damaged area, and only after that a fixing bandage.
With a bruise of the heart, accompanied by pain in the chest, low blood pressure and heart palpitations, medications that block pain are used. As a rule, they are administered intravenously. Transportation of victims is possible only in a supine position with a slightly raised upper body on a stretcher. With cardiac tamponade, transportation is carried out in a half-sitting position using a stretcher. Without exception, all injured with chest injuries need urgent medical attention. For this patient, they are taken to the nearest surgical department, where doctors stop bleeding, and also use pain-relieving drugs and drugs to support heart function. Additionally, oxygen inhalations are used.
In the case of cardiac tamponade, a pericardial puncture is necessary. From the needle with which the pericardium was pierced, blood begins to run continuously. She is not taken out until the patient is taken to the hospital, where doctors will stop the bleeding completely. Also, with the development of valvular pneumothorax, the doctor punctures the pleural cavity with a needle, and then removes the air and blood accumulated there.
How to transport with a chest wound?
Transportation of the victim should be carried out in compliance with certain rules regarding the position in which he is. Thus, the escort must pay particular attention to the position in which the wounded is transported. Help should be given to bring him into a semi-sitting position with bent knees. Bringing the victim in this position, it is necessary to put a roller under it. Transportation should also be carried out in accordance with the following principles:
- efficiency;
- safety - ensuring the patency of the respiratory tract of the victim, ensuring gas exchange, as well as access to the respiratory bed;
- sparing attitude - it is not allowed to inflict pain on the injured person by not observing the transportation conditions, as this can lead to a shock state.
The probability of saving the life of the wounded depends on the success of the transportation, in particular, on the position taken. Thus, adherence to the principles of transportation is one of the most important points in first aid for injuries to the chest area.
Treatment
Necessary primary medical care is to find how to treat an open wound, applying a bandage with a thick layer of sterile cotton wool covered with a bandage, the edges should be several centimeters larger than the diameter of the damage. It will also help stop the flow of air into the tissue with a special patch.
Before transporting the wounded, painkillers should be administered:
For bullet wounds, the fragmented parts or severe bruises should be removed surgically. This will help prevent sepsis and further tissue decay.
Bruise treatment
With a severe bruise of the chest, it is necessary to provide the patient with free access to oxygen, enter an anesthetic blockade. Regardless of the type of chest injury, an X-ray is required to fully understand the extent of the damage.
Only after this, further treatment is prescribed and a decision is made about whether surgery is necessary. With a mechanical tremor of the chest, the victim has a shock condition and there are problems with spontaneous breathing. In this case, it is required to organize the flow of air artificially.
Open Wound Treatment
In case of open, lacerated injuries, it is necessary to stop bleeding. Also, with injuries of this nature, suturing cannot be dispensed with. In case of fracture of the ribs, 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, for example, hemorrhage. In the hospital, the ribs will be fixed in the correct position using a special corset. Radiography should not be neglected, since it can be used to detect the presence of fragments that need to be removed surgically. Over the period of the healing process (from 4 to 7 weeks), painkillers, for example, Novocain, are used.
When injuring the lungs, it is first necessary to apply a tight bandage during exhalation. Do not let the victim lose consciousness from blood loss, as this can even lead to death. Further, the wounded requires artificial respiration, taking measures to treat soft tissues with antiseptic agents to prevent infection and suturing. Later, when injuring the lungs, regular dressings are primarily necessary in order to avoid the appearance of purulent wounds.