Treating a Sucking Chest Wound

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.

Watch a video showing this technique.

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. 

Read more about inserting a chest tube, 

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.

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.


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Bureau of Medicine and Surgery
Department of the Navy
2300 E Street NW
Washington, D.C

Operational Medicine
 Health Care in Military Settings
CAPT Michael John Hughey, MC, USNR
  January 1, 2001

United States Special Operations Command
7701 Tampa Point Blvd.
MacDill AFB, Florida

*This web version is provided by The Brookside Associates, LLC.  It contains original contents from the official US Navy NAVMED P-5139, but has been reformatted for web access and includes advertising and links that were not present in the original version. The medical information presented was reviewed and felt to be accurate in 2001. Medical knowledge and practice methods may have changed since that time. Some links may no longer be active. This web version has not been approved by the Department of the Navy or the Department of Defense. The presence of any advertising on these pages does not constitute an endorsement of that product or service by either the US Department of Defense or the Brookside Associates. The Brookside Associates is a private organization, not affiliated with the United States Department of Defense.

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