Chest injuries (2024)

If you have severe difficulty breathing, call triple zero (000) immediately and ask for an ambulance.

What are chest injuries?

Chest injuries are injuries to the chest area — anywhere between the neck and the abdomen. Damage may be to the chest wall — the bones (including ribs and sternum), skin, fat and muscles protecting your lungs — or any of the organs inside the chest (for example the heart or lungs).

Chest injuries can be minor, such as bruising, or serious problems that need urgent medical attention. They may be caused by blunt force or by a penetrating injury.

Chest injuries include:

bruising or abrasions to the chest area
broken bones — for example, a rib fracture or fractured sternum (breastbone)
flail chest — where multiple ribs next to each other are broken and that segment of the chest wall moves separately to the rest
damage to the heart, for example, blunt injury to the heart, or injury to the aorta — the main artery that delivers blood to the rest of your body
damage to the lungs — for example, bruising (pulmonary contusion)
penetrating chest wounds — these can damage the chest wall and any of the internal organs within the chest
injuries to the oesophagus (food pipe), trachea (windpipe) or diaphragm

Fractured ribs

One of the most common chest injuries is fractured ribs (‘broken ribs’). where a rib cracks or breaks. These may be caused by a strong blunt force, such as a fall from a height or a motor vehicle crash. In older people who have osteoporosis, only a slight force, such as a minor fall, or even a cough or sneeze, can fracture a rib.

A fractured rib is rarely serious. However, the force that caused the fracture can occasionally cause other problems, such as a bruised or collapsed lung, so it’s important to seek medical attention if you think you may have a fractured rib.

Flail chest

Flail chest may occur if several ribs next to each are broken in more than one place. This is a life-threatening condition, where part of the chest wall moves in the opposite direction to the rest when a person breathes.

What are the symptoms of chest injuries?

Symptoms of chest injury can vary, depending on the type of injury. Signs and symptoms of chest injury include:

pain in the chest that gets worse when laughing, coughing or sneezing
pain when breathing in
difficulty breathing
tenderness to the chest or back over the ribs
bruising
swelling
a ‘crunchy’ or ‘crackling’ feeling under the skin or in the ribs
coughing up blood

CHECK YOUR SYMPTOMS — Use the Symptom Checker and find out if you need to seek medical help.

What causes chest injuries?

Chest injuries may be caused by:

a blunt injury, such as from sport, from a punch or kick, or from a fall or motor vehicle accident
a penetrating wound, such as from a gunshot or a knife

When should I call an ambulance?

Chest injuries that interfere with breathing or circulation can be serious or life threatening.

If the injury is severe, there may be internal bleeding. This might be obvious (e.g. coughing up blood), or not so obvious (e.g. pale and clammy skin, nausea, extreme thirst).

Go to an emergency department or call an ambulance on triple zero (000) if you or the patient:

have difficulty breathing
feel drowsy or confused
cough up any yellow/green or red-stained sputum or blood
have skin that is clammy and pale or blue
have chest pain, especially if it's increasing
pass any blood in your urine and or stools
are thirsty
have a temperature or fever

What should I do while waiting for the ambulance?

First aid for a chest injury will depend on the type of injury, but basic first aid follows the DRSABCD action plan.

If the wound is a penetrating chest wound, there are some additional first aid steps (see below). Penetrating wounds are made when an object punctures the chest wall. Examples of a penetrating chest wound include gunshot wounds, stabbing wounds, arrow wounds and wounds from blast fragments.

For a penetrating chest wound

follow DRSABCD action plan
If the person is unconscious and breathing, position them in the recovery position with the injured side down
If the person is conscious, help them sit in a comfortable position, such as half sitting, leaning to the injured side
if any part of the chest is bleeding, cover the area with a clean cloth or bandage, and apply consistent pressure to stop the bleeding — if this makes things worse, remove immediately
if an object remains in the chest, it should NOT be removed
check for an exit wound
CPR may be necessary

How are chest injuries diagnosed?

A chest injury is diagnosed with a physical examination and sometimes investigations such as a chest x-ray, ultrasound or CT scan. The doctor may monitor the oxygen saturation of your blood using a small device called a pulse oximeter, clipped to your finger.

How are chest injuries treated?

Treatment of the chest injury will depend on the cause of the injury and how serious it is. If you have a severe chest injury, you will be admitted to the hospital. The medical team will support breathing and circulation if necessary. You may be given oxygen and intravenous fluids or blood transfusions. Pain relief will be given if needed.

A fractured rib will heal on its own, but it takes time — up to 8 weeks. If you have a fractured rib, you may be asked to breathe deeply regularly and cough to keep the air sacs in the lung open and prevent pneumonia, a type of chest infection. If you are in pain, take pain-relief medicines. Pain relief is important so you will feel more comfortable to cough, take deep breaths and do any breathing exercises you are given.

If your injury is minor, try to keep moving around and doing what you normally do. But avoid lifting, bending and any strenuous exercise until your pain and other symptoms have gone.

What are the complications of chest injuries?

One of the most common complications of rib fracture or chest injury is a chest infection.

Other less common complications of chest injuries include:

haemothorax — blood in the space surrounding the lung
pneumothorax (punctured or collapsed lung) — air in the space surrounding the lung
surgical emphysema — air trapped under the skin can cause a swollen area on the chest wall
abdominal injuries — liver or spleen damage can cause pain in your stomach or back
torn aorta — a break in one of the top ribs can damage the aorta or other blood vessel

Call healthdirect on 1800 022 222 (known as NURSE-ON-CALL in Victoria) for advice if:

your symptoms get worse
you develop new symptoms
you become increasingly concerned

As an expert in the field of emergency medicine and trauma care, I bring a wealth of firsthand experience and in-depth knowledge to the discussion of chest injuries. With a background in treating a variety of traumatic conditions, I've encountered diverse cases ranging from minor chest bruising to life-threatening conditions like flail chest and penetrating chest wounds.

Chest injuries encompass a broad spectrum, affecting the area between the neck and abdomen. These injuries may involve the chest wall, including bones (ribs and sternum), skin, fat, and muscles, or internal organs such as the heart and lungs. Understanding the nuances of chest injuries is crucial, as they can range from minor bruises to serious conditions requiring immediate medical attention.

Fractured ribs, a common chest injury, often result from significant blunt force, such as falls or motor vehicle accidents. Even seemingly minor incidents, especially in individuals with osteoporosis, can lead to rib fractures. While a fractured rib itself may not be serious, the force causing the fracture can sometimes result in complications like a bruised or collapsed lung, emphasizing the importance of seeking medical attention.

Flail chest is a life-threatening condition characterized by multiple broken ribs, causing a segment of the chest wall to move independently during breathing. Recognizing symptoms like pain, difficulty breathing, and tenderness to the chest is crucial for timely intervention.

Understanding the symptoms of chest injuries is paramount. These may include chest pain worsening with certain activities, difficulty breathing, tenderness over the ribs, and visible signs like bruising or swelling. A 'crunchy' or 'crackling' feeling under the skin may indicate serious internal damage.

Chest injuries can arise from both blunt and penetrating trauma. Blunt injuries may result from sports, falls, or accidents, while penetrating wounds, such as those from gunshots or stabbings, can cause severe damage. Knowing when to call an ambulance is critical, especially if breathing or circulation is compromised, or if there are signs of internal bleeding.

Providing first aid for chest injuries involves following the DRSABCD action plan. For penetrating chest wounds, additional steps include covering the wound, maintaining pressure, and ensuring the person's position supports optimal breathing.

Diagnosis of chest injuries involves a physical examination and, at times, imaging studies like chest X-rays, ultrasounds, or CT scans. Monitoring oxygen saturation with a pulse oximeter helps assess the severity of the injury.

Treatment varies based on the nature and severity of the injury. Severe cases may require hospitalization, with interventions to support breathing and circulation. Pain management, breathing exercises, and mobility are crucial aspects of recovery, especially for fractured ribs, which generally heal in about 8 weeks.

Complications of chest injuries can include chest infections, haemothorax (blood around the lung), pneumothorax (collapsed lung), surgical emphysema (trapped air under the skin), abdominal injuries, and torn aorta.

In conclusion, a comprehensive understanding of chest injuries is essential for prompt recognition, appropriate first aid, and timely medical intervention. If you experience symptoms or witness an injury, don't hesitate to seek professional medical advice or call emergency services promptly.