Chest Injuries | Chapter 29

Chest injuries are among the most time-sensitive trauma emergencies an EMT may encounter. In this chapter we examine how to recognize, assess, and provide initial prehospital care for blunt and penetrating chest trauma. This lecture connects thoracic anatomy and the mechanics of ventilation with the clinical findings associated with pneumothorax, hemothorax, cardiac tamponade, rib fractures, flail chest, pulmonary contusion, traumatic asphyxia, blunt myocardial injury, commotio cordis, and injuries to the great vessels. Topics covered include: • Chest anatomy and the mechanics of ventilation • Ventilation versus oxygenation • Tidal volume and minute ventilation • Open versus closed chest injuries • Blunt and penetrating mechanisms of injury • Chest-trauma scene size-up and primary assessment • DCAP-BTLS examination of the chest • Bilateral chest expansion and breath-sound assessment • Signs of respiratory distress, respiratory failure, and shock • Simple, open, and tension pneumothorax • Sucking chest wounds and vented chest seals • One-way flutter valves and chest-seal reassessment • Hemothorax and hemopneumothorax • Cardiac tamponade and Beck’s triad • Rib fractures and flail chest • Paradoxical chest movement • Pulmonary contusions • Sternal and clavicular fractures • Traumatic asphyxia • Blunt myocardial injury • Commotio cordis, CPR, and early defibrillation • Traumatic aortic and great-vessel injuries • Rapid transport and ongoing reassessment This lesson is designed for EMT students, EMR students, paramedic students, EMS educators, firefighters, athletic trainers, and NREMT candidates reviewing chest trauma, thoracic emergencies, trauma patient assessment, and prehospital emergency care. The lecture aligns with Chapter 29 of Emergency Care and Transportation of the Sick and Injured, 13th Edition, and reinforces the knowledge and assessment priorities expected in an entry-level EMT course. Subscribe to The Sideline Medic for complete EMT lectures, NREMT preparation, patient-assessment breakdowns, trauma education, medical-emergency reviews, and practical EMS instruction. Educational Notice: This video is provided for educational purposes and does not replace formal EMS education, hands-on skills training, local treatment protocols, online medical direction, or the policies governing your scope of practice. Always follow your current state, county, agency, and medical-director requirements. #EMT #NREMT #ChestInjuries