Treating Chest or Abdominal Wounds

The chest wall protects the lungs, heart and other essential organs such as the liver. A puncture wound to the chest can therefore be extremely serious. Wounds to the abdomen (stomach and intestines) are very serious. External bleeding may be severe and internal bleeding is likely, both of which will lead to serious shock. In addition, there may be damage to internal organs and the digestive system.

Chest wounds

Common complications of penetrating chest wounds include:

• Collapsed lung (pneumothorax), caused by air entering the space between the chest wall and the lungs. This applies pressure to the lungs, causing them to collapse. The lung can also be damaged directly, causing it to fill with blood.
• Tension pneumothorax which occurs when the pressure builds up sufficiently to affect the uninjured lung and possibly even the heart.
• Damage to vital organs such as the liver - this will result in severe shock as these organs have a large blood supply.

Signs and symptoms of chest wounds

• Difficulty with breathing
• Shock
• Bright red, frothy blood (blood with air in it) being coughed up or escaping from the wound
• Pale skin with blue lips
• sound or air being sucked into the chest

First Aid Treatment

1. Seal the wound using, in the first instance, your hand or the casualty's hand.
2. Help the casualty into a position that makes it easier for him to breathe. This will usually be sitting up and inclined to the injured side. This allows the uninjured lung maximum room to move and allows blood to pool on the injured side.
3. Cover the wound with a dressing and cover the dressing with airtight material, such as plastic or foil. Seal this on three sides.
4. Call an ambulance and treat for shock.

If the casualty is unconscious, monitor and maintain the airway and be prepared to resuscitate if necessary (sealing the wound before resuscitating). Place the casualty injured side down.

Treating abdominal wounds

1. Call an ambulance and help the casualty to lie down in the most comfortable position.
2. Consider the position of the wound. If it is vertical - runs down the abdomen - moving the casualty so that he is lying flat on the ground will help bring the edges together, ease discomfort and help reduce bleeding. If the wound is horizontal, gently raising the legs will have the same effect.
3. Place a large dressing over the wound and secure in place. Add pads to this dressing as necessary.
4. Treat for shock.

Major organs

Damage to any of the body's major organs can be life-threatening and prompt action must therefore be taken to minimise the effects of injuries to the chest or abdomen. Even when external bleeding is slight, the risk of internal bleeding cannot be discounted. Knowing whereabouts in the body the organs are located will help a first aider to assess a situation and decide the most appropriate emergency treatment, and also to give accurate information when the emergency services arrive.