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Chest Trauma Management

Jun 17, 2025

Overview

This video covers the recognition and management of chest trauma, focusing on blunt trauma, penetrating trauma, and impaled objects, with practical pre-hospital guidance for each.

Channel Updates

  • Upcoming review and giveaway of individual first aid kits (IFAKs) on the channel.
  • Next week’s video may be delayed or absent due to attendance at SWAT school; updates will be shared via Instagram and YouTube.

Types of Chest Trauma

Blunt Force Trauma

  • Results from impacts like falls or car accidents, causing internal chest injuries without penetration.
  • Assess for rib stability, crepitus, unequal chest movement, and pain to identify fractures or pneumothorax.
  • Tension pneumothorax may result from internal lung injury due to pressure or rib displacement.
  • Flail chest occurs with multiple adjacent ribs fractured in two places, compromising normal breathing.

Penetrating Trauma

  • Includes injuries like stab or gunshot wounds penetrating the chest wall.
  • Sucking chest wounds allow air into the chest cavity, risking lung collapse and hypoxia.
  • Treat with occlusive chest seals over the wound to prevent air ingress; use vented seals when available.
  • Always check for both entrance and potential exit wounds and cover both as needed.
  • Monitor closely for development of tension pneumothorax after sealing a wound.
  • “Burping” the chest seal or needle decompression may be required if tension pneumothorax is suspected.

Impaled Objects

  • Do not remove impaled objects, as they may be tamponading (controlling) internal bleeding.
  • Stabilize objects with bulky dressings and secure them to prevent movement.
  • Oxygen therapy and assisted ventilation may be necessary as supportive measures.
  • Only remove impaled objects if they obstruct the airway or interfere with required CPR.

Management and Treatment

  • Blunt trauma: Provide supportive care, oxygen, pain management, and transport to hospital; field interventions are limited.
  • Penetrating trauma: Apply occlusive dressing, manage both entry and exit wounds, and expedite transport.
  • Impaled object: Stabilize in place, provide supportive care, and rapidly transport.

Decisions

  • Do not remove impaled objects unless causing airway obstruction or impeding CPR.
  • Monitor all chest trauma patients for signs of developing tension pneumothorax.

Action Items

  • TBD – Video Creator: Announce and conduct upcoming IFAK giveaway via Instagram and YouTube.
  • TBD – Video Creator: Attempt to record a video at SWAT school, respecting participant privacy and rules.

Questions / Follow-Ups

  • Viewers are encouraged to ask further questions in the video comments for clarification or additional information.