What are chest injuries?

Chest injuries are injuries to the area between your neck and abdomen (tummy).

Damage may be to:

• your chest wall — this includes your bones, muscles, fat and skin
• the organs or blood vessels inside your chest, including your heart and lungs

Chest injuries can cause:

• bruising, cuts or scrapes to your chest wall
• fractured (broken) bones, such as the collarbone or sternum (breastbone)
• dislocated joints
• damage to your heart or blood vessels, including your aorta (the main artery that delivers blood from your heart to the rest of your body)
• damage to your lungs, such as pulmonary contusions (bruising) or a laceration (cut)
• a collapsed lung
• cardiac tamponade — this is a serious condition where fluid builds up around the heart, preventing it from pumping blood properly

Fractured ribs

One of the most common chest injuries is fractured ribs. Fractured ribs can cause:

• pneumothorax — when air leaks into the space between your lungs and your chest wall
• haemothorax — when blood collects in the space between your lungs and your chest wall
• flail chest — when 2 or more ribs next to each other are broken in more than one place. This makes part of the chest wall loose.

What are the symptoms of chest injuries?

The symptoms of chest injuries vary, depending on the type of injury.

Symptoms of a chest injury include:

• bruising on your chest
• bleeding
• pain in your chest
• difficulty breathing or fast, shallow breathing
• abnormal movement of your chest when you breathe
• a 'crunchy' or 'crackling' feeling under the skin of your chest
• abnormal sounds when you breathe

If you have a very serious chest injury, you may:

• look pale
• lose consciousness or collapse
• have a fast heart rate
• have low blood pressure

When should I call an ambulance or go to the emergency department?

If your chest has been seriously injured, for example after a fall, accident or assault, call triple zero (000) immediately and ask for an ambulance.

Serious chest injuries need urgent medical attention. Call an ambulance or go to the emergency department if you have a chest injury as well as:

• changes to your breathing
• changes to your circulation (blood flow)
• a fever (temperature of 38℃ or higher)
• coughing up any yellow, green or red stained sputum
• chest pain
• blood in your urine (wee) or stools (poo)
• clammy or pale skin

Chest injuries can be minor, such as bruising. Even minor chest injuries should be checked by your doctor. Your doctor can tell you what to do if your symptoms get worse.

What should I do while waiting for the ambulance?

If first aid is needed, follow this action plan while waiting for the ambulance:

• Lie the person down.
• If the person is unconscious and breathing, place them on their side.
• If any part of their chest is bleeding, cover the area with a clean cloth or bandage, and apply consistent pressure to stop the bleeding — if this makes the bleeding worse, remove it immediately.
• If an object remains in the chest, it should NOT be removed. Do not put pressure on the object, but place bandages around it.
• Cardiopulmonary resuscitation (CPR) may be needed if the person is not responding and not breathing properly.

If first aid is not needed, stay with the person and keep them comfortable until the ambulance arrives.

What causes chest injuries?

Chest injuries may be caused by:

• blunt chest trauma — this is when your chest is injured by a strong force without the skin being broken. This may happen because of a punch, kick, fall or car accident.
• penetrating trauma — this is when an object punctures your chest wall. This may happen from a gunshot or a knife wound.

Penetrating injuries may have separate entry and exit wounds.

How is a chest injury diagnosed?

Your doctor will ask about your symptoms and do a physical examination.

They may recommend tests, such as:

• a chest x-ray
• an ultrasound scan
• a computed tomography (CT) scan
• blood tests
• an electrocardiogram (ECG)

These tests are often done in hospital if you have had a serious chest injury.

How is a chest injury treated?

Treatment of a chest injury will depend on the:

• cause of your injury
• type of injury you have

If you have a severe chest injury, you will need treatment in hospital. You may need to have:

• supplementary oxygen to help you breathe
• pain-relief medicines
• intravenous (IV) fluids (fluids given directly into your vein)
• monitoring of your breathing and heart
• surgery to treat your injury
• chest physiotherapy

Fractured ribs

A fractured rib will heal on its own. It can take up to 8 weeks for a fractured rib to heal completely.

If you have a fractured rib, you may be asked to breathe deeply and cough regularly. This helps to prevent pneumonia.

You should also:

• take pain-relief medicines if you are in pain
• do gentle exercise, such as walking
• do any breathing exercises you are given
• cough when necessary — it may help with your symptoms to hug a pillow when you cough
• not exercise strenuously
• avoid any contact sports for 4 weeks
• avoid lifting heavy items for 4 weeks

What are the complications of a chest injury?

One of the most common complications of chest injuries is a chest infection, such as pneumonia.

Other complications include:

• blood clots
• breathing problems
• damage to organs such as your spleen, liver or kidneys

In rare cases, severe chest injuries can be life-threatening.

Can chest injuries be prevented?

Chest injuries can't always be prevented, but there are some things you can do to lower your chance of a chest injury. This includes:

• wearing a seatbelt when driving or in a vehicle
• keeping your floors free of trip hazards
• following the rules of your sport and wearing the right protective equipment
• following workplace safety guidelines

Resources and support

The St John Ambulance page offers information on:

• how to provide first aid to a major wound
• severe bleeding
• what to have in a first aid kit

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with you 24 hours a day, 7 days a week.