c. Treatment for Hemothorax. Follow the general principles of treating for
hypovolemic shock (shock caused by a decrease in the amount of blood circulating in
Survey the casualty and maintain the airway, if necessary.
Reassure the casualty.
(3) Position the casualty. Place the casualty in the Fowler's position
(elevate the casualty's head about 20 inches).
(4) Administer oxygen. Establish an airway (clear the casualty's airway of
obstructions and/or secretions and insert an oropharyngeal or endotracheal tube, if
necessary). Then administer oxygen by mask or nasal catheter.
(5) Initiate intravenous infusion (IV). Use serum albumin in the IV fluid
because serum albumin draws fluid into the tissue. Run the IV flow wide open until the
blood pressure returns to normal and stabilizes; then, decrease the flow to one drop per
second. Start as many IVs as possible if shock is severe.
(6) Maintain the casualty's normal body temperature. In cool temperatures,
place the casualty on a poncho and cover him with the sides of the poncho. Use a wool
blanket if you have one. DO NOT allow the casualty to lie in water. In hot or warm
temperatures, DO NOT cover the casualty unless he shows signs of chilling. Watch the
casualty for signs of sweating and/or chilling. Remove covering if the casualty is
sweating. Cover the casualty if he shows signs of chilling.
(7) Check vital signs. Check the casualty's vital signs and other symptoms
as often as possible to see if he is responding to treatment. Check for consciousness,
blood pressure, pulse rate, respirations, and skin color.
(8) Evacuate the casualty. Record the treatment and evacuate the casualty
to the nearest medical facility as soon as possible.
DO NOT drain the pleural space while you are in the field.
1-10. SIMPLE PNEUMOTHORAX
Simple pneumothorax is the presence of air within the pleural space. It results
from blunt or penetrating trauma. Ninety percent of such injuries are associated with
blunt trauma to the ribs. The fractured rib(s), in turn, cause injury to the pleura.