Treating Chest or Abdominal Wounds and Crush Injuries, Impalement, and Amputation

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 intestine) 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 lungs 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.

TREATMENT

1. Seal the wound using, in the first instance, your hand or the victim's hand.
2. Help the victim 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 victim is unconscious, monitor and maintain the airway, and be prepared to resuscitate if necessary (sealing the wound before resuscitating). Place the victim injured side down.

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 of air being sucked into the chest

TREATING ABDOMINAL WOUNDS

1. Call an ambulance and help the victim 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 victim 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.

Support the wound if the victim coughs, vomits, or needs to be moved into the recovery position. Press lightly on the bandage to prevent intestines protruding from the wound. If intestines are protruding, do not attempt to replace them. Cover with a clean piece of plastic film.

CRUSH INJURIES, IMPALEMENT, AND AMPUTATION
Crush injuries generally result from serious car accidents or explosions. There may be part of the body trapped under heavy debris; several broken bones, multiple external bleeding and much internal bleeding; burns from an explosions; severe shock, and deterioration into unconsciousness. If a person is impaled on an immovable object, treatment is similar to that for a foreign object embedded in a wound. An amputation is where a part of the body has been severed. This may occur through a straight and heavy cut or through twisting and pulling under extreme force.

TREATING CRUSH INJURIES

1. Ensure that it is safe to approach the scene. If in doubt, call 911 and wait for help.
2. Monitor and maintain airway and breathing and be prepared to resuscitate in necessary.
3. Treat major bleeding and cover smaller wounds with sterile dressings.
4. Keep the injure person still and try to reassure him or her while waiting for help.
5. Treat for shock.
6. Make an early call for an ambulance and inform medical staff what has happened.

IF THE INJURED PERSON IS TRAPPED. There are additional risks for the injured person if any part of the body is trapped. Releasing the body may bring on severe shock as fluid leaks to the injured part.

     An ever greater cause for concern is "crush syndrome." Toxins build up around the injury site and are trapped by an object crushing the person. If the object is removed, these toxins are suddenly released into the body, and the kidneys, the organs chiefly responsible for flushing out toxins, are overwhelmed. This condition can be fatal.

IF THE PERSON HAS BEEN TRAPPED FOR LESS THAN 10 MINUTES. Crush syndrome take some time to develop. If you can do so, safely remove the object. Treat as for crush injuries.

IF THE PERSON HAS BEEN TRAPPED FOR LONGER THAN 10 MINUTES. Make an early call for help, explaining the situation, but do not remove the object. Treat as for crush injuries and reassure the person.

TREATING AN IMPALEMENT

1. Do not attempt to remove the object or to move the injured person.
2. Provide swift assistance for the injured person, supporting his body weight where possible to prevent any further damage.
3. If bleeding is severe, apply pressure around the edges of the wound without pressing on the object.
4. Try to stop the object moving around as much as possible, enlisting bystander support where available.
5. Call an ambulance, make sure that you explain the need for cutting equipment or tools.
6. Treat for shock as best you can.

 TREATING AMPUTATION

1. Your priority is to stop any bleeding at the site of injury. Apply direct pressure and raise the injured stump. An amputation high on the arm or leg can be accompanied by severe arterial bleeding, particularly if caused by a twisting or tearing movement. Be prepared to apply continuous pressure using several pads as necessary.
2. If the bleeding comes under control, cover the wound with a sterile dressing or clean non-fluffy material tied in place with a bandage.
3. Treat for shock and reassure the person.
4. Call 911, advising that there is an amputation.

FOR THE AMPUTATED PART

A surgeon may be able to reattach the amputated part.

1. Wrap the part in a plastic bag and wrap the bag in a clean cloth.
2. Place the cloth-wrapped bag in ice and place into a sturdy container. Do not let the ice come into close contact with the amputated part, because this will damage the flesh. Do not wash the amputated part.
3. Label the container with the time of injury and the victim's name and make sure that you personally hand it over to medical staff.

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Frederick Luneta is a 24-year old guy and he is a Computer Engineering student and a young part time blogger. Currently lives in the Philippines. He knows a lot about computer.