Major Chest Injury

The thoracic cavity can best be described as the area that starts at the bottom of the neck and extends down to the diaphragm. The contents of the thoracic cavity include the heart, lungs and the great blood vessels. All of these vital components of the thoracic cavity are protected by the ribs. The muscles of the thoracic cavity assist in breathing but also offer a partial protection to the organs.

Injuries that are concentrated to directly or around the thoracic area are considered to be in most cases life threatening or at the very least an important factor in deciding transport decisions in pre-hospital settings. This is due to the heart for one is contained in the thoracic cavity as well as the diaphragm that assists us in our breathing via inhale and exhale.

A thoracic injury may be of blunt force trauma rather than penetrating trauma, meaning that the injury may not be visible from the exterior or with the naked eye. A check of the vitals of a patient will be able to assist you in seeing some of these changes from a blunt force trauma in some cases. In other cases you may not know until it is too late. This is why like we mentioned earlier that most thoracic injuries are considered life threatening in nature.

Thoracic trauma can affect the heart as much to cause cardiac output to decrease, therefore decreasing blood pressure which then in turn will decrease the amount of oxygen, blood, and other needed substances reaching certain parts of the body such as cells and organs that need the substances to maintain adequate perfusion. Once this happens the patient can go into shock. At this point a pre hospital care provider must correct the apparent life threats if possible or to the best of their abilities and this is only if said apparent life threats are visible.

Rib fractures are another injury related to the thoracic area that is considered or I should say in most cases should be considered life threats especially in the elderly. A fractured rib is considered a life threat due to the fact that not only can the rib be fractured causing pain but it can also affect breathing as well as puncture an organ or other vital part of the body. This is another example of some of the not so visible life threats of the thoracic area.

Of course you can have penetrating punctures that are apparent and even though they are apparent it does not necessarily mean that they are able to be maintained or controlled at the scene. All of this goes along with patient assessment and transport decision in the pre hospital setting.

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