University of Santo Tomas

Faculty of Pharmacy
Pharmaceutical Care 1

Presented by:
Prince-Jerome S. Biscarra
I. DEFINITION
Chest trauma/injury
-is defined as the damage to a
structure in the chest, caused by
an injury.

Minor injuries may cause a bruise

to the chest wall, while severe
injuries may also damage the
lungs or heart.
II. CLASSIFICATION / TYPE
Chest trauma injuries are divided into two major
categories:

1. PENETRATING TRAUMA

2. BLUNT TRAUMA

*In some situations, both types of chest trauma

are present.
 are caused by bullets (gunshots), knives, and
other items that puncture the skin and enter
the chest.

 Most chest trauma caused by penetrating

injuries is due to stabbings, violent crimes,
suicide or homicide attempts and military
attacks.
PENETRATING INJURIES
PENETRATING INJURIES
PENETRATING INJURIES
PENETRATING INJURIES
PENETRATING INJURIES
 bullet on the
heart

PENETRATING INJURIES
 occurs when the body is slammed into a
stationary object, such as a steering wheel.

 Could either be:

-direct blow (e.g. rib fracture)
-deceleration injury
-compression injury
 Motor vehicle accidents are the most
common cause of blunt chest trauma.

 Also common in the area of sports and other

strenous activities.

 Blunt trauma can also occur in situations

such as a fall from a significant height, like a
roof.
Injury may affect the chest wall and thoracic
cavity such as:

 bony skeleton (ribs, clavicles, scapulae, sternum)

 lungs and pleurae
 tracheobronchial tree
 esophagus
 heart
 great vessels of the chest
 diaphragm
Car accidents, one of the common cause...

BLUNT INJURIES
BLUNT INJURIES
BLUNT INJURIES
Airway obstruction
Tension pneumothorax
Open pneumothorax “sucking chest wound”
Massive hemothorax
Flail chest
Cardiac tamponade
Lung contusion
Heart contusion
Aorta rupture
Diaphragm rupture
Tracheobronchial tree injury
Esophagus trauma
Subcutaneous emphysema
Traumatic asphyxia
Simple pneumothorax
Hemothorax
Scapula fracture
Rib fractures
III. SIGNS AND SYMPTOMS
EARLY s/sx:
Restlessness, Irritability
Dyspnea (difficulty in breathing)
Rapid & Shallow breathing
Chest pain
– Worsens during a deep breath
– Worsens during coughing
– Worsens during movement of the chest
Chest wall contusion/bruising
Tenderness & swelling at site of injury
Open chest wounds
III. SIGNS AND SYMPTOMS
LATE s/sx:
Deformed Chest
Loss of Consciousness or Fainting
Severe difficulty breathing:
– Chest indrawing or rib retractions
– Nasal flaring
– Use of accessory muscles
– Mouth breather
Cyanosis (bluish discoloration of skin, mucous membrane, lips &
nail beds)
Hemoptysis (coughing out blood)
III. SIGNS AND SYMPTOMS
LATE s/sx:
Flail chest (rib breakage)
Crunching sounds in the ribs
Distended neck veins
Subcutaneous emphysema (air in the skin)
Tracheal deviation
Shock
IV. FIRST AID
FIRST THINGS FIRST!
DO THE BASIC FORM OF FIRST AID...
1. Assist the victim to sitting in an
upright position or place them with
the injured area facing upwards.
*Placing the individual in this position will
protect the uninjured side from blood
inside the chest cavity. It will further allow
the good lung room to expand.
2. To assist the victim in preventing
pneumonia, strongly encourage the
victim with this type of chest-wall
injury to clear their lungs by
coughing on an hourly basis, despite
1. Stabilize the ribs using a pillow,
blanket or other kind of soft object.
2. Have the victim hold the soft object
firmly against the injured area.
3. You may further stabilize the area by
tying the object in place around the
person's body. Just tight enough to
hold the object in place, but not too
tight as to cause the victim more
pain or damage to the chest.
4. Once again, in order to prevent
pneumonia, have the victim cough at
1. Never try to remove an impaled
object. *Removal of the object is very
dangerous as it could cause more damage
to the injured person.
2. Instead, after monitoring the victim’s
vital signs using the A, B, C, D first aid
method, call for emergency medical
assistance.
3. Stabilize the object to keep it from
moving.
4. You can do this by using a bulky
dressing or padding around the
1. This wound should be sealed
immediately.
2. Have the injured person take a
breath and then release the air.
3. Following the exhalation of air, seal
the open wound with anything
available larger than the wound that
will stop air from entering the chest
cavity.
*A plastic bag or plastic wrap would be the
most useful material for sealing this type of
chest wound.
4. Once the plastic is in place, tape the
material to the body, leaving one
corner untaped to create a flutter
valve. This will prevent air from
being trapped in the chest cavity.
5. If the injured person begins to
develop difficulty breathing or if
their condition worsens, remove
your hand or plastic material and
allow air to escape. Then reapply
the covering once more.