Patient education: Chest trauma (The Basics)

What is chest trauma? — 

This is when the chest gets hit, such as during an accident, fall, sports injury, or assault. It is also called "blunt chest trauma." Chest trauma might cause problems with breathing.

Many types of injuries can happen with chest trauma. Examples include:

●Bruises – Skin, muscles, and other soft tissues often get bruised.

●Broken bones, also called "fractures" – Rib injuries are common with chest trauma. The sternum (also called the "breastbone") or bones in the spine can also break.

●Pneumothorax – This happens when air gets trapped between the lung and the ribcage. It is also called a "collapsed lung."

●Bruised lung, also called a "pulmonary contusion" – This is when fluid and blood gathers inside the small air sacs in the lungs. It can cause breathing problems and other problems.

●Damage to the heart or blood vessels – The heart can get bruised or develop an abnormal rhythm. The heart or blood vessels like the aorta (the main blood vessel that comes out of the heart) can tear or rupture.

What are the signs and symptoms of serious chest trauma? — 

The symptoms are based on the type of injury. Many people have chest pain, pain with breathing, or bruising of the chest.

In general, signs and symptoms of serious chest trauma can include:

●Trouble breathing or needing to take shallow, fast breaths

●Chest movement that is not normal or not equal on both sides

●Fast heart rate or breathing fast

●Coughing up blood

●Wheezing

●Skin that is blue or gray in color or paler than your normal color

How is chest trauma treated? — 

It depends on your specific injuries.

The doctor will ask about your symptoms and medical history, and do an exam. They will measure the amount of oxygen in your blood with a "pulse oximeter."

They might also order tests, like:

●X-rays, ultrasound, a CT scan, or other imaging tests – These take pictures of the inside of the body.

●Lab tests

You might need emergency care to drain blood, fluid, or air from the space between your lungs and ribcage. For very serious problems, you might also need surgery. If you are having a hard time breathing, you might need extra oxygen or a breathing tube.

Depending on your injuries, you might need to stay in the hospital. The staff will check your oxygen levels often and help with your pain.

How do I care for myself at home? — 

Ask the doctor or nurse what you should do when you go home. Make sure you understand exactly what you need to do to care for yourself. Ask questions if there is anything you do not understand. 

You should also do the following:

●Take all your medicines as instructed:

•If you have an infection, you might get antibiotics. It is important to finish all the antibiotics, even if you start to feel better.

•If your doctor prescribed pain medicines, follow all instructions for taking them. You can also take non-prescription medicines to relieve pain, such as acetaminophen (sample brand name: Tylenol). If the doctor says it's safe, you can take ibuprofen (sample brand names: Advil, Motrin) or naproxen (sample brand name: Aleve) as well.

●Cough and take deep breaths to help prevent a lung infection:

•Do breathing exercises as prescribed. If the doctor gave you an "incentive spirometer," use it as instructed. You can also take 10 to 15 deep breaths at least 4 times each day.

•Hold a pillow to your chest to ease pain when you take deep breaths, sneeze, cough, or laugh.

•Take pain medicine as needed. This will help you feel more comfortable so you can cough and take deep breaths.

●Increase your activity slowly when you no longer have pain while resting. Start with short walks around your home, and walk a little more each day. Avoid heavy lifting and sports for at least 3 weeks. (Your doctor or nurse will tell you exactly how long to avoid these or other activities.)

●Ice can help with pain and swelling – Put a cold gel pack, bag of ice, or bag of frozen vegetables on the injured area every 1 to 2 hours, for 15 minutes each time. Put a thin towel between the ice (or other cold object) and your skin. Ice for at least 6 hours after the injury. It might help to ice longer, even up to 2 days.

●It might hurt less to sleep in a recliner. You can also sleep with your head and shoulders propped up on pillows.

●Keep any wounds clean and dry for the first 24 hours. Then, you can gently wash the wounds with soap and water or take a shower.

•Always wash your hands before and after you touch the wound or bandage.

•Put an antibiotic ointment on the wound 1 to 2 times each day. You can cover the wound with a bandage. Or you can leave it open to air.

●Quit smoking, if you smoke. Your doctor or nurse can help.

When should I call the doctor? — 

Call for emergency help right away (in the US and Canada, call 9-1-1) if:

●You cough up blood.

●The pain in your chest or belly suddenly gets worse or gets very bad.

●You have so much trouble breathing you can only say 1 or 2 words at a time.

●You need to sit upright to breathe, or cannot lie down.

●You are very tired from working to catch your breath, or are sweating from trying to breathe.

●You feel very weak, pass out, or think you might pass out.

Call for advice or return to the emergency department if:

●You a fever of 100.4°F (38°C) or higher, or chills.

●You have trouble breathing when talking or sitting still.

●You feel lightheaded, dizzy, or unsteady when you walk.

●Your skin is pale.

●You vomit or have belly pain.

●You have blood in your urine.

●You cough up yellow or green mucus.

●You have bad pain even after taking pain medicines.

More on this topic

Patient education: Taking care of bruises (The Basics)
Patient education: Fractures in adults (The Basics)
Patient education: Fractures in children (The Basics)
Patient education: Rib injury in adults (The Basics)
Patient education: Caring for an open wound (The Basics)
Patient education: Pneumothorax (collapsed lung) (The Basics)
Patient education: Thoracentesis (The Basics)
Patient education: How to use an incentive spirometer (The Basics)

Patient education: Thoracentesis (Beyond the Basics)