Figure 3-12. Hemothorax resulting from a closed chest injury.
3-24. TREAT A CASUALTY WITH TENSION PNEUMOTHORAX
A casualty with tension pneumothorax resulting from a closed chest injury
should treated as soon as possible. A chest needle decompression should be
performed. Maintain an open airway and assist with respiration if needed. Administer
oxygen if available. Monitor the casualty for tracheal deviation or mediastinal shift.
3-25. CHECK FOR OTHER CONDITIONS
a. Subcutaneous Emphysema. Subcutaneous emphysema is caused by air
from a damaged lung becoming trapped in the soft tissues of the chest wall. The
trapped air forms little bubbles that cause a crackling sensation when palpated. A
casualty with subcutaneous emphysema should be given respiratory support and
b. Pulmonary Contusion. A pulmonary contusion is a bruise of the lung,
usually caused by a blunt instrument or fall. Edema fluid and blood accumulates in the
lung tissue. This accumulation interferes with the respiratory process and results in
hypoxia (oxygen deficiency). A casualty with a pulmonary contusion should be given
respiratory support and evacuated.
c. Myocardial Contusion. A myocardial contusion is a bruise of the heart
muscle and is usually caused by a blunt injury to the chest. The casualty will have an
irregular pulse with occasional pauses between heartbeats at times and a very rapid
pulse at other times. A casualty with a suspected myocardial contusion should be