The evaluation of a chest injury begins with a medical history and physical examination.

Physical findings in patients with a serious chest injury may include:

• Abdominal tenderness
• Chest tenderness
• Chest bruising
• Chest swelling
• Decreased lung sounds
• Wheezing
• Different blood pressure between the arms and legs
• Elevated blood pressure in one arm
• Low blood pressure
• Chest crepitation:
• A crunchy or spongy feeling to the chest caused by air in the soft tissues
• Rapid pulse
• Rapid breathing
• Signs of severe difficulty breathing:
• Rib retractions
• Nasal flaring
• Use of accessory muscles
• Cyanosis

Tests are necessary to determine the severity of most chest injuries.

Tests that may be used to evaluate a chest injury include:

• Complete blood count
• Urinalysis
• EKG
• Chest x-ray
• Rib x-rays
• Sternum x-ray
• Cardiac enzymes
• Cardiac monitoring
• Pulse oximetry
• CT scanning of the chest
• Echocardiogram
• Aortography
• Pulmonary angiogram