Figure 3-8. Examples of proper needle insertion.
d. If the ability to perform a needle decompression is not available loosen the
bandages and lift the sealing material so the trapped air escapes from the pleural
cavity. Then apply the sealing material to the wound again and tie the bandages.
Section III. TREATING CLOSED CHEST INJURIES
3-14. IDENTIFY A CASUALTY WITH A CLOSED CHEST INJURY
In a closed chest injury, the chest is injured but there is no break in the skin. A
closed chest injury can be caused by a blow to the chest by a blunt instrument, a fall, a
cave-in, or a vehicle accident. The following are signs and symptoms of a closed
a. Pain in the chest area. The pain may be due to injury to the rib cage and
muscles (pain indicates the site of the injury) or to pleurisy (inflammation within the
chest cavity). The pain usually increases when the casualty breathes.
b. Labored breathing or difficulty in breathing (dyspnea).
c. Diminished breathing sounds or absence of such sounds.
d. Rapid and weak pulse with low blood pressure.
e. Cyanosis (bluish tint) usually seen first in the lips, nail beds, or inside the
f. Failure of one or both sides of the chest to expand normally when the