Regional Emergency Medical Advisory Committee of New York City
Prehospital Basic Life Support Protocols
Copyright January 1996 (8/96)

423 CHEST INJURIES

Monitor the airway.

Observe spinal injury precautions, if appropriate. (See Protocol #421.)

Administer oxygen.

NOTE:DO NOT USE A DEMAND VALVE RESUSCITATOR DUE TO THE POSSIBILITY OF CAUSING SEVERE, LIFE-THREATENING COMPLICATIONS.

Monitor breathing for adequacy.

Control external bleeding.

For Special Considerations, see below.

Assess for shock and treat, if appropriate. (See Protocol #415.)

Position the patient on the affected side unless it will complicate the injury.

Transport. (See Appendix F.)

NOTE:DECREASED BREATH SOUNDS AND MUFFLED HEART SOUNDS INDICATE LIFE-THREATENING CHEST INJURIES. THE PATIENT SHOUL BE TRANSPORTED IMMEDEIATELY.

SPECIAL CONSIDERATIONS

OPEN CHEST WOUND

Seal the wound with an occlusive dressing and tape on three sides.

If the patient's condition worsens, unseal the occlusive dressing to vent the pressure as the patient exhales, reseal after exhalation, and request Advanced Life Support assistance.


CLOSED CHEST WOUND

If a the patient's condition worsens, request Advanced Life Support assistance.


FLAIL CHEST

Secure bulky dressings with tape over the flail segment.


IMPALED OBJECTS

Do NOT remove the object.

Support and secure the object with bulky dressings.

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