Chest injury

Broken ribs

Direct force applied to the chest wall can break ribs, causing pain with deep breathing, coughing, or sneezing. An injury to the ribs can damage the underlying structures causing bruising or collapse of a lung (pneumothorax). If the right lower ribs are broken, be alert to the possibility of a bruised or cracked liver, which lies directly below; if the left lower ribs are broken, the underlying spleen might be injured causing internal bleeding or signs of shock. Broken ribs can more rarely be caused by severe coughing fits especially in victims over the age of 65. When broken ribs cause pain sufficient to limit deep breathing, pneumonia also becomes a risk. Victims should be monitored for underlying lung or abdominal injury, treated for pain, and encouraged to take occasional deep breaths to fully expand their lungs. Broken ribs can range in severity from moderate discomfort to life-threatening injury.