I am recently in the process of teaching first aid personnel on how to manage traumatic injuries. In the case of a penetrating injury to the chest (like a knife stab), we will teach them to give oxygen, maybe a chest seal, and then rapid transport to a trauma hospital. Guidelines state that if the patient needs to be in a recovery position, the injured side of the thorax should be facing upward.
Could anyone help me explain why the upward position is the best position for a penetrating injury to the chest? Is there a physiological explanation? Or is it more a practical question? I can easily see that having the injuries facing upwards is more practical during transport for inspection and treatment.
Jørgen Melau - Thank you for your question. I enclose an excellent article about the pre-hospital management of chest injuries. Please read it, and you will get an answer to your questions.
In short about your question, penetrating chest injuries, the patient will have respiratory distress because he will develop pneumothorax on that side. The physiological explanation is patients with respiratory distress, as it is with severe asthma, are using their extra-respiratory muscles to help them with the hyperaemia. Therefore, they have to be sitting and possibly leaning forward. In such position, patients are using more muscles as a physiological mechanism to increase the delivery of air into their respiratory system and oxygenation of blood. This is one of the main reasons.
Thank you very much - that helped me a lot. I cant see your mentioned article? Did you link to it?
Jørgen Melau - I enclose a copy of the paper - pre-hospital management of chest injuries. Good luck.
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