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 Emergency & First Aid: First Aid for Chest Pain 
 
American Institute for Preventive Medicine ©
Chest pain can come from a lot of things.

Causes of chest pain that need emergency medical care include:

  • Heart attack
  • Injury such as to the chest wall or lung
  • Collapsed lung
  • Blood clot that has traveled to a lung (pulmonary embolism)

Other causes of chest pain include:

  • Lung problems such as pneumonia or bronchitis (if severe enough, these might also need emergency care)
  • Hiatal hernia
  • Heartburn
  • Shingles
  • Pulled muscle
  • Anxiety
  • Swallowing too much air

How do you know when you need medical help for chest pain? It's not always easy to tell. If you're not sure why your chest hurts, it's best to check it out. Getting help for a heart attack, lung injury or other serious conditions, could save your life.

Questions to Ask

Is the person not breathing and has no pulse?Yes: Seek CareGive First Aid
No
Do CPR and Get Emergency Care
Is the person not breathing, but has a pulse?Yes: Seek CareGive First Aid
No
Do rescue breathing and Get Emergency Care
Is the victim unconscious, but is breathing and does have a pulse?Yes: Seek CareGive First Aid
No
Get Emergency Care and give first aid for unconsciousness
Do any of these symptoms come with the chest pain?
  • Pain that spreads (radiates) to the arm, neck or jaw
  • Feeling of pressure, especially on the left side
  • Shortness of breath or trouble breathing
  • Nausea and/or vomiting
  • Sweating
  • Uneven pulse or heartbeat
  • Feeling anxious
Yes: Seek CareGive First Aid
No
Get Emergency Care. Give first aid for a heart attack before emergency care:
  • Ask the victim if he or she uses heart medicine (nitroglycerin). If yes, ask where it is, find it and place the nitroglycerin tablet under the tongue. Give as many as 3 tablets in a 10 minute time span if necessary.
  • Help the victim get into a comfortable position. Do not have the victim lie down, especially if he or she has breathing problems. A half-sitting position is better - with the legs up and bent at the knees. Put a pillow or rolled towel under the knees. Support the back.
  • Reassure the victim that you have called for help and will stay with him or her until you get help.
  • Loosen any clothing around the victim's neck, chest and waist.
  • Monitor the victim for breathing and pulse. Do CPR or Rescue Breathing, if necessary. (See CPR.)
Did the chest pain result from a serious injury?Yes: Seek CareGive First Aid
No
Get Emergency Care and give first aid before emergency care.
  • Do CPR if no breathing and no pulse (see "CPR").
  • Do Rescue Breathing if no breathing, but victim has a pulse.
  • Stabilize the injured area

For an object stuck in the chest:

  • Don't try to remove it
  • Pack the object in place with padding and put tape around the padding so it doesn't move
  • Keep the object from being hit or moved

For an open chest wound:

  • (See "Cuts, Scrapes and Punctures" for first aid to control bleeding.)
  • Cover the wound with gauze, a plastic bag or plastic wrap. Tape in place to seal it except for one corner. (This keeps outside air from getting into the chest cavity, but allows any trapped air to escape.)
  • Have the victim sit up or at least elevate the victim's head and shoulders. Or, position the victim with the injured side down.
  • Get the victim to cough a few times every 1/2 hour. (This will help clear the lungs even though it hurts.)
  • Give the victim a small dose of a pain reliever to help with the pain if he or she can take one.

For a fractured rib:

  • If the rib has broken through the skin, apply an airtight dressing. Hold the dressing in place with tape and your hand.
  • Get the victim to lie down

If the broken rib has not pushed through the skin:

  • Keep the rib from moving. Place a broad bandage, pillow or other soft object against the injured area. Hold or tape in place. The bandaging should not be so tight that it restricts breathing. Have the victim hold the bandaging in place if he or she can.
  • Get the victim to take deep breaths and to cough a few times every half hour.
Does the chest pain occur in a person who has had a recent operation or illness that has kept them in bed and does he or she have the following symptoms, too?
  • Shortness of breath
  • Fainting or faintness
  • Low fever
  • Cough (with or without blood in the sputum)
  • Fast heartbeat
  • Pain and swelling in a leg prior to the symptoms listed directly above
Yes: Seek Care
No
Is there trouble breathing along with the chest pain? Does it get worse when taking deep breaths?Yes:See Doctor
No
Are one or more of the following present?
  • Fever
  • Cough with sputum of any color (pink, green, yellow, gray, etc.)
Yes:See Doctor
No
Do belching and/or a burning sensation in the upper abdomen come with the chest pain? Does it come and go before, during or after eating and does it get worse when bending or lying down?Yes:See Doctor
No
Does the chest pain stop with antacids and do you have to take antacids often?Yes:See Doctor
No
Do any of these describe the chest pain?
  • It's only on one side of the chest
  • It's not affected by breathing
  • It comes with a burning feeling and a skin rash at the pain site
Yes:See Doctor
No
Self-Care

Self-Care

Self-care for chest pain from a pulled muscle or minor injury to the rib cage:

  • Do not strain the muscle or ribs while pain is felt.
  • Rest.
  • Take a pain reliever such as aspirin, acetaminophen or ibuprofen.

    (Note: Do not give aspirin or any medication containing salicylates to anyone 19 years of age or younger unless a doctor tells you to.)

  • Do call your doctor if the pain lasts longer than two days.

Self-care for chest pain from a hiatal hernia:

  • Lose weight if you are overweight.
  • Eat 5-6 frequent meals, instead of 3 meals a day. Do not eat large meals.
  • Avoid tobacco, alcohol, coffee, spicy foods, peppermint, chocolate, citrus juices and carbonated beverages.
  • If you have heartburn, take antacids after meals and before going to bed.
  • Do not eat food or drink milk two hours before going to bed.
  • Avoid bending over or lying down after eating.
  • Do not wear tight clothing, tight belts, or girdles.
  • Raise the head of your bed about 3 to 4 inches (40 degree angle) when you sleep.

Self-care for chest pain from anxiety and hyperventilation:

  • Talk over the source of your anxiety with family, friends and clergy. If this is not enough, you may need the help of a professional counselor or psychiatrist.
  • When you hyperventilate, cover your mouth and nose with a paper bag. Breathe into the paper bag slowly and re-breathe the air. Do this in and out at least 10 times. Remove the bag and breathe normally a few minutes. Repeat breathing in and out of the paper bag as needed.
  • Avoid using large amounts of aspirin or other salicylate-containing medicines. (Note: Do not give aspirin or any medication that has salicylates to anyone 19 years of age or younger unless a doctor tells you to.)
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Disclaimer: The information provided on HealthWorld Online is for educational purposes only and IS NOT intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek professional medical advice from your physician or other qualified healthcare provider with any questions you may have regarding a medical condition.
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