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With an open chest wound, the lung is unable to remain expanded.
Place an occlusive patch over the wound, covering it completely and
extending 2 inches beyond the wound.
Tape it on three sides.
With each exhale, air in the chest is pushed out from underneath the
occlusive patch. With each inhale, the patch sticks to the skin, keeping
air from coming back into the chest.
Place a battle dressing over the patch. Don't make it so tight the
casualty can't breath.
Roll the casualty onto the side of the wound while awaiting transport.
If the tape won't stick (because of blood, perspiration or water), hold
the occlusive patch in place with a battle dressing. It won't work as
well, but it will work well enough to be helpful.
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A sucking chest wound is identified by the sucking or
hissing sound made during breathing by the casualty.
With this type of wound, the chest cavity is no
longer sealed, allowing air to rush through the wound and into the chest
during inhalation. This causes the lung to collapse. This is a
life-threatening condition and requires immediate treatment.
Start by uncovering the wound. If the clothing is
stuck to the wound or in a chemical environment, then clothing should not
be removed. Don't attempt to clean the wound. That will be done later.
Use the casualty's hand to cover the wound while you
quickly prepare an occlusive patch. The plastic wrapper of a battle
dressing works very well, although any air-tight material can be
substituted, such as:
-
Cellophane
-
Aluminum
foil
-
Duct
Tape
-
Vaseline
Gauze
The patch should be large enough to extend 2 inches
beyond the edge of the wound. Smaller patches tend to get pulled back into
the wound.
Secure the patch to the wound with adhesive tape.
Three sides should be taped, while the 4th side is left untaped.
Whenever the casualty breaths out (exhales), air is expelled from the
chest cavity and escapes from underneath the open edge of the patch.
Whenever the casualty breaths in (inhales), the patch sticks to the skin
and keeps air from returning into the chest cavity. This helps to
re-inflate the collapsed lung.
Place a small battle dressing over the patch, but
don't make it so tight that the casualty can't breath.
Sometimes, you won't have any adhesive tape, or the
tape won't stick (blood, water, mud, or perspiration may keep it from
sticking). In that case, it is still very helpful to use the patch, held
in place by a battle dressing or triangular bandage.
Finally, roll the patient onto the injured side while
awaiting transportation.
Some medical bags include pre-packaged chest seals.
These are easy to use and fast.
·
Use the enclosed gauze pad to wipe the skin dry around the
wound.
·
Peel off the paper backing and place the sticky side of the
seal over the wound and surrounding skin
·
The one-way flutter valve will allow air to be expelled from
the chest, but will keep the outside air from returning.
Read
more about chest seals
As a first aid measure, patching the
chest can be life-saving. To more fully re-inflate the lung, you may need
to place a chest tube.
Watch a Video on
Inserting a Chest Tube
Read
more about inserting a chest tube,
This section was developed from "Treat an Open (Sucking) Chest Wound,"
A1701-93-000086, Health
Sciences Media Division, US Army Medical Department C&S, Fort Sam Houston, Texas. Approved for public release; Distribution is unlimited.
The listing of any non-Federal product in this CD is not an
endorsement of the product itself, but simply an acknowledgement of the source.
Operational Medicine 2001
Health Care in Military Settings
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Bureau of Medicine and
Surgery
Department of the Navy
2300 E Street NW
Washington, D.C
20372-5300 |
Operational
Medicine
Health Care in Military Settings
CAPT Michael John Hughey, MC, USNR
NAVMED P-5139
January 1, 2001 |
United States Special Operations Command
7701 Tampa Point Blvd.
MacDill AFB, Florida
33621-5323 |
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The presence of any advertising on these pages does not constitute an
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