Chest wounds, penetrating
LIFE-THREATENING DISORDERDepending on their size, penetrating chest wounds may cause varying degrees of damage to bones, soft tissue, blood vessels, and nerves. Mortality and morbidity from a chest wound depend on the size and severity of the wound.
Gunshot wounds are usually more serious than stab wounds, both because they cause more severe lacerations and rapid blood loss and because ricochet commonly damages large areas and multiple organs. Patients require prompt, aggressive treatment to increase survival.
Causes
Stab wounds from a knife or ice pick are the most common penetrating chest wounds; gunshot wounds are a close second. Wartime explosions or firearms fired at close range are the usual source of large, gaping wounds.
Signs and symptoms
In addition to the obvious chest injuries, penetrating chest wounds can also cause several other effects:
A sucking sound occurs as the diaphragm contracts and air enters the chest cavity through the opening in the chest wall.
Level of consciousness varies, depending on the extent of the injury. If the patient is awake and alert, he may be in severe pain, which will make him splint his respirations, thereby reducing his vital capacity.
Tachycardia stems from anxiety and blood loss.
A weak, thready pulse results from massive blood loss and hypovolemic shock.
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