During the rapid assessment of a critically-injured patient, what should you assess in the chest?

• A. Symmetry and pain.
• B. Rigidity and guarding.
• C. Distention and guarding.
• D. Crepitus and distention.

Answer: (A)

During a rapid trauma chest assessment, you quickly look for how the chest is moving and where the patient hurts. Symmetry of chest expansion tells you if both lungs are inflating properly; unequal movement can indicate a pneumothorax, flail chest, or other injury that could compromise breathing. Asking about and palpating for chest wall tenderness helps identify rib fractures or other chest injuries that require attention.

The other options mix signs that aren’t the primary rapid chest indicators. Rigidity and guarding point to abdominal issues, not the chest. Distention and guarding likewise focus on the abdomen. Crepitus can occur with chest injuries but isn’t as reliable a quick measure of chest function as symmetry and pain on palpation.