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:
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
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.
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.
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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