The concept of injury
First aid for a fracture of the chest bones
A fracture of the chest bones includes all damage to the anatomical region of the human skeleton in the anterior frontal projection. In this case, both the chest wall itself and the organs located in the chest region are injured.
Soft tissues of the sternum wall, ribs, vertebrae of the thoracic region, pleura, lungs, bronchi, heart, pericardium, large vessels, diaphragm, nerve fibers, esophagus and lymphatic connections lend themselves to deformation. It can occur both with direct impact (damage as a result of the use of force), and as a result of a fracture of the ribs with damage to the lung tissue, the vascular system.
Fractures can be either isolated, occurring in a specific place, or multiple. A feature of chest injury is the structure of the rib cage, which serves to protect the chest organs from external mechanical damage. Often, it is he who becomes the source of secondary damage to the chest region due to fragments of the ribs, often damaging the lung tissue.
Chest injuries are divided into open (in case of injury) and closed (in the absence of damage to the skin). When closed, damage to the bone frame and organs of the chest occurs. Sometimes there is a combined injury of the diaphragm and abdominal organs.
With open injuries, the integrity of the parietal pleura or soft tissues of the chest wall is violated.
Signs of injury
The main and main symptom is very intense pain directly at the site of the fracture. It is aggravated by breathing or physical activity. Breathing with a stethoscope is heard in all parts of the lung.
Other signs of a fracture include:
- A slight decrease in blood pressure and the presence of a slight tachycardia (rapid heartbeat);
- Swelling and subcutaneous hemorrhage at the fracture site;
- When you press your finger on the area of damage, a sharp pain is felt;
- A characteristic crackling sound heard at the height of inhalation. Occurs with a fracture only at the beginning of exhalation. Or a crunch is heard on palpation;
- In the presence of displacement at a fracture, deformation of the chest is visible, the sternum is shortened;
- Breathing is rapid and intermittent, there is a cyanosis of the nasolabial triangle and shortness of breath.
- If the vessels or the integrity of the lungs / bronchi are damaged – hemoptysis.
With a combined injury, there is a traumatic shock, obvious disorders of the respiratory function. Symptoms of a fracture of the sternum are fully consistent with the above manifestations.
Fracture of the xiphoid process of the sternum
The xiphoid process is the lower part of the sternum. It has the shape of a blade or sword. It is connected to the body of the sternum with the help of movable fibrous bands. It is an attachment point for the large pectoral muscles.
The xiphoid process serves as a guideline for cardiopulmonary resuscitation. It is the intense pressure on it that leads to a rupture of the cartilage connection between it and the body of the sternum. As a result, there is a fracture of the xiphoid process and piercing of the diaphragm and liver.
Fracture of the body of the sternum
The body of the sternum is an elongated bone located between the handle and the xiphoid process. Along the edges it has rib cutouts for articulation with the cartilages of the true ribs. A fracture of the body of the sternum occurs with a direct mechanical sharp impact on it. Leads to rupture of the rib joints at the border of the VIIІ rib. Freely walking ribs can pierce the lungs, pericardium, lead to rupture of the bronchi and diaphragm.
Depending on the traumatic object, the rib may break in one or two places. With a high kinetic energy of a traumatic object, comminuted fractures occur. A fracture of one rib is called isolated, a fracture of several ribs is called multiple. By themselves, rib fractures are not dangerous and heal quickly enough, the danger is concomitant damage to internal organs. With multiple fractures of the ribs, fragments can move in different directions, injure nearby tissues and organs, and cause dangerous complications.
The main causes of trauma leading to fractures are:
- Intense and direct blow to the chest. The most common example of such an injury is hitting the steering wheel in an accident.
- A strong punch or kick to the chest.
- Mechanical compression of the sternum between two surfaces.
- Falling chest down onto a hard surface.
- Indirect fractures – a sharp bending of the body forward and backward.
The fracture occurs most often in such a way that the lower fragment lies on the upper one and in front of it.
First aid for a fracture of the sternum, first of all, lies in the fact that the victim must be laid on his back on a hard surface, after placing a roller of clothes, a pillow or a large folded towel under his shoulder blades. The upper part of the body must be raised.
* ensure immobility of broken bones, do not move, do not try to change shape, do not pull unless absolutely necessary;
* apply a cold compress to the fracture site;
* with an open fracture, treat and bandage the wound; stop the bleeding. Do not set the wreckage;
* if self-transportation is to be carried out, it is necessary to ensure the immobility of the wreckage during transportation. To do this, transport tires are applied to the limbs, fractures of other bones of the skeleton are fixed with bandages or the position of the victim’s body.
What not to do with a fracture of the chest
Do not allow the victim to talk a lot, take deep breaths, do not offer water or food, and do not leave him alone until the ambulance arrives.