Chest injuries usually fall into one of three categories: penetrating wounds, blast injuries, and broken bones.

Penetrating wounds allow air from the outside to enter the lungs directly. This causes breathing difficulties similar to those of Asphyxia; blood may be coughed up; the wound itself may make sucking noises.

The first thing to do is cover the hole in the chest to prevent the air from getting in; polythene and adhesive tape make an effective seal, and will make breathing easier. Then sit the casualty upright, leaning his or her body to one side so that the undamaged lung is uppermost. Dial 911.

Blast injuries are caused when the chest is compressed by a sudden increase in air pressure due to an explosion. Again, there may be signs of Asphyxia there may be other internal injuries, and the person may also be in a state of panic, which further interferes with breathing.

Do not move the casualty unless it is absolutely necessary, to avoid further danger.

Examine him or her and treat the most serious condition first. Then dial 911.

Fractures of the ribs or breastbone, usually due to falls, blows, or crushing injuries, cause intense pain at the slightest movement. A stove-in chest, in which several ribs may have been broken, causes ‘paradoxical’ breathing- the ribs are sucked in on inhalation and out on exhalation, the opposite of what normally happens. Breathing will be difficult; there may also be Internal bleeding.

Fold the arm across the chest on the injured side and bandage it in place. Position the casualty in a half-sitting position with the uninjured side uppermost. Dial 911.