You are transporting a young and healthy female patient who was involved in a motor vehicle collision, during which she struck her chest on the steering column. Although the primary assessment reveals no life threats, the patient does have redness to her sternum, as well as pain and tenderness. Breath sounds are clear and present bilaterally, and vital signs are within normal limits. As you transport and reassess this patient, which sign or symptom would indicate the immediate need for ALS?

Emergency medical technicians (EMTs) should rapidly recognize and treat chest trauma, which can be fatal if patients are not stabilized before transport. Chest trauma can be categorized into two areas: Injuries that cause significant blood loss and Injuries that compromise ventilation.  Primary assessment treatments include: Manual stabilization of the cervical spine Establishing and maintaining a patent airway Determining the patient's level of consciousness using the AVPU scale    Chest injuries can be caused by: Penetrating trauma, such as gunshots, lacerations, and punctures Blunt... Show more

Emergency medical technicians (EMTs) should rapidly recognize and treat chest trauma, which can be fatal if patients are not stabilized before transport. Chest trauma can be categorized into two areas: Injuries that cause significant blood loss and Injuries that compromise ventilation. 

Primary assessment treatments include:
Manual stabilization of the cervical spine
Establishing and maintaining a patent airway
Determining the patient's level of consciousness using the AVPU scale 
 

Chest injuries can be caused by:
Penetrating trauma, such as gunshots, lacerations, and punctures
Blunt trauma, such as motor vehicle accidents, falls, crush injury, blasts, and burns 

Signs of chest injury include:
Pain in the chest that gets worse when laughing, coughing or sneezing
Pain when breathing in
Difficulty breathing
Tenderness to the chest or back over the ribs
Bruising
Swelling
A 'crunchy' or 'crackling' feeling under the skin or in the ribs
Coughing up blood 

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