There are several other specific traumatic injuries that warrant mentioning. Among them, chest injuries, impaled objects, dental injuries, open abdominal injuries and burns. Each of these injuries require special attention either by seriousness or method of treatment.

Chest injuries can be categorized two ways; blunt trauma or penetrating trauma. Blunt trauma is usually caused by a car accident or falling. The majority of penetrating wounds result from guns and knives. Regardless of the type of injury, your concern lies with injured structures below the surface of the skin and difficulty breathing as a result of those injuries. The most unique aspect of blunt trauma is large surface area involvement with no opening into the actual chest area. Because of the surface area involved, a variety of body parts may be injured. Ribs may be broken and the organs found in the chest, including the heart, lungs, liver and pancreas may be damaged.

Your main treatment priority for a closed chest trauma is to ensure EMS is on the way. From your mechanism of injury evaluation, you may suspect a spinal cord injury. IF that is the case, keep the patient fiat on their back with their spine in a neutral position; straight, with no twists or bends. If you do not suspect a spinal cord injury, the patient can remain in the position in which they are most comfortable. Continue your assessment and monitor the patient's level of responsiveness, paying close attention to their airway and breathing.

A common side effect of blunt chest trauma is broken ribs. This may manifest as one broken rib, several broken ribs or a full segment of broken ribs. The term "flail chest" refers to one or more ribs broken in more than one spot. In this case, the chest wall may bulge in and out with each breath due to the broken portion floating separately from the other ribs. A flail chest is a very serious injury, not only because of the fractured ribs, but because of potential damage to the lungs underneath.

Any penetrating trauma to the chest wall is a potential life threat. EMS should be notified immediately. These wounds can quickly result in difficulty breathing. The patient is also at increased risk of infection due to the open wound. In some cases the injury will not only penetrate the chest wall, but may create a hole in the lung.

This dramatic injury is sometimes called a `sucking chest wound' and can cause breathing problems as well as bleeding. To treat any penetrating chest wound, make certain you cover it with an airtight dressing that will seal the wound. This will allow your patient to breathe easier and can help prevent a collapsed lung. Your gloved hand, saran wrap or tin foil works nicely to create this `occlusive' dressing. If you use your gloved hand, you will be able to do little else. If a first aid kit is available, tape three sides of the occlusive dressing over the wound. This allows you to continue your assessment and care for the patient.

Impaled objects are actually quite common and can range from bullets to fence posts to fish hooks to knives. Any object that penetrates the body is potentially a life threat. The object may still be impaled in the patient when you arrive. In most cases, more damage can result from removing an impaled object than from leaving it in place. Your priority should be to stabilize the object in place until it can be removed surgically at a hospital.

To stabilize an impaled object you may need to hold it manually at first. Be careful to hold it as still as possible. Stabilizing the object further may take the help of a second rescuer. Have them place bulky dressings, such as rolled towels, on all sides of the impaled object. Then, tape across the dressings to hold the object in place. These are worrisome injuries to the patient, so a little extra reassurance may need to be given as you monitor the ABC's.

Eye injuries pose a special set of circumstances. Our eyes do not work independently of each other. When your left eye moves, so does your right. For this reason, it is imperative to stabilize the object in the injured eye, then minimize movement of the other eye by covering it. A Styrofoam cup works well to protect impaled objects in the eye. Simply place the cup over the object and secure it to the face. A gauze pad can be placed over the non-injured eye to minimize movement.

Occasionally, trauma will result in the amputation of a body part. More often than not, fingers or toes are involved. In more serious cases, an entire extremity may be involved. Your main priority is bleeding control and patient reassurance. Care for the amputated parts is:

Advances in microsurgery often allow successful reattachment of amputated body parts, sometimes even hours after the injury. The key to successful reattachment is often directly linked to the care the body part received at the emergency scene. Again, you can make a difference!

An avulsed tooth is one that is knocked completely out of the socket. First aid centers on care for the tooth and timeliness. Many avulsed teeth can be re-implanted successfully when not too much time passes. If you can find the tooth, pick it up by the crown (the portion you normally see in your mouth). Place the tooth into a clean glass of milk or water to retain its moisture. Your patient should get to a dentist or emergency room within 1 hour for the most success.

Fractured teeth are often the result of golf clubs, baseball bats and sibling's heads. A fractured tooth is much like a broken china cup. The break lines are not clean and tidy, there are usually microscopic pieces missing. Therefore, it is not necessary to retain the fractured portion. Pain, swelling and sensitivity to hot and cold are the most common symptoms of a fractured tooth. You may treat the pain with analgesics and cold compresses. Your dentist will need to restore the tooth with dental materials.

Trauma to a tooth is much like trauma to any other body part. The teeth may actually turn dark or bluish in color as a result of the trauma. This is similar to a bruise. The bruising may go away and the tooth may be fine, or the tooth may abscess and need nerve treatment. Any dental injury should be evaluated by a dentist as soon as possible to acquire baseline information and perform necessary treatment.

Although open abdominal injuries are extremely rare, you may one day encounter an injury that has allowed abdominal organs to protrude through the skin. After you control any bleeding that is present, your next priority is to protect the abdominal cavity and exposed organs. Never attempt to push the organs back in. Cover them with a wet, sterile dressing and tape the dressings gently in place. The risk for infection and shock in this patient is extremely high, so a delay in calling 911 may put the patient in a life-threatening situation. As you may expect, this type of injury is particularly frightening to the patient. Continually reassure the patient while you monitor ABC's.