ST JOHN AMBULANCE: How to deal with rib injuries

St John Ambulance, the nation's leading first aid charity has teamed up with the Herald and Gazette to bring you some simple, but life saving, first aid tips '“ this week: dealing with rib injuries.

Place the arm on the injured side in a sling to provide extra support
Place the arm on the injured side in a sling to provide extra support

One or more ribs can be fractured by direct force to the chest from a blow or a fall, or by a crush injury.

If there is a wound over the fracture, or if a broken rib pierces a lung, the casualty’s breathing may be seriously impaired.

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An injury to the chest can cause an area of fractured ribs to become detached from the rest of the chest wall, producing what is called a ‘flail-chest’ injury.

The detached area moves inwards when the casualty breathes in, and outwards as he breathes out.

This ‘paradoxical’ breathing causes severe breathing difficulties.

Fractures of the lower ribs may injure internal organs such as the liver and spleen, and may cause internal bleeding.

Symptoms might include:

• Bruising, swelling or a wound at the fracture site.

• Pain at the site of the injury.

• Pain on taking a deep breath.

• Shallow breathing.

• If there is a wound over the fracture, you may hear air being ‘sucked’ into the chest cavity.

• Paradoxical breathing.

• Signs of internal bleeding and shock.

Follows these simple steps:

• Help the casualty to sit down and ask them to support the arm on the injured side; help them if necessary.

• For extra support, place the arm on the injured side in a sling.

• Arrange to take or send the casualty to hospital.

Do not allow the casualty to eat or drink as an anaesthetic may be necessary.

If the casualty loses consciousness, open the airway and check breathing.

If they need to be placed in the recovery position, lay them on their injured side to allow the lung on the uninjured side to work to its full capacity.

• For those looking for quick, easily accessible first aid information, the St John Ambulance app is available free on smartphones and the website ( offers demo videos, an interactive game, and lots of free advice. For more information about first aid courses please call 0303 003 0101.


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