ORGANS AND CAVITIES WITHIN THE CHEST
a. Lungs. The body has two lungs. Each lung is enclosed in a pleural cavity,
which is an airtight area within the chest. Each pleural cavity is separate and
independent of the other pleural cavity. If an object punctures the chest wall and
allows air to enter one pleural cavity, the lung within that cavity begins to collapse (not
expand fully). The other lung, however, will not collapse. Any degree of collapse,
though, interferes with the ability to inhale a sufficient amount of air. A buildup of
pressure from air or blood around the collapsed lung can also cause compression of
the heart and the other lung.
b. Heart. The heart is located in the pericardial cavity. The pericardial cavity
is located between the lungs in a space called the mediastinum. In addition to the
heart, the mediastinum contains the lower part of the trachea, part of the esophagus,
large blood vessels, and the thymus.
Section II. TREATING OPEN CHEST WOUNDS
IDENTIFY A CASUALTY WITH AN OPEN CHEST WOUND
An open chest wound is a wound in which the skin and the chest wall are
penetrated. An open chest wound can be caused by a bullet, knife blade, shrapnel, or
other object. Some of the signs and symptoms of an open chest wound are given
a. Sucking or hissing sounds coming from chest wound. When a casualty with
an open chest wound inhales, air goes in the wound. When he exhales, air escapes
from the wound. This airflow sometimes causes a "sucking" or "hissing" sound.
Because of this distinct sound, an open chest wound is often called a "sucking chest
b. Difficulty in breathing (dyspnea).
c. Visible puncture wound in the chest (front or back). If you are not sure if a
wound has penetrated the chest wall completely, treat the wound as though it were an
open chest wound.
d. Impaled object protruding from the chest.
e. Frothy blood or air bubbles in the blood around the wound site.
f. Bright red or frothy blood being coughed up.
g. Sputum containing blood.