ch13 presentation chest_abdominal_pelvic_injuries
TRANSCRIPT
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Chapter 13Chest, Abdominal, and
Pelvic Injuries
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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.
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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 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.
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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
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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.
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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
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Flail Chest: What to Do
• Do not apply constrictive bandages around the chest.
• Call 9-1-1.
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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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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.
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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.
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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
• Occur when the internal abdominal tissues are damaged but the skin is unbroken
• Examine by gently pressing all four quadrants.
© Jones & Bartlett Learning.
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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.
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Open Abdominal Injury
• Open abdominal injuries are those in which the skin has been broken.− Also called penetrating injuries
• Stab wounds• Gunshot wounds
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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.
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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.
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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.
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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
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Pelvic Injuries: What to Do
• Call 9-1-1.• Do not move person.• Keep person lying flat.• Treat for shock.