How should a penetrating chest wound be managed (suspected pneumothorax)?

• A. Apply an occlusive dressing taped on three sides to allow air escape; monitor for signs of tension; call EMS.
• B. Leave the wound uncovered to vent air.
• C. Apply a loose dressing and avoid pressure.
• D. Only apply a pressure bandage without occlusion.

Answer: (A)

The main idea is to seal a penetrating chest wound while still allowing air to escape if pressure builds inside the chest. An occlusive dressing taped on three sides achieves this: it seals the wound to prevent air from being drawn into the chest, but leaves one edge open to vent air as the person breathes. This reduces the risk of a tension pneumothorax while you arrange further care. After applying this dressing, monitor the person for signs of worsening condition such as increasing trouble breathing, chest tightness, bluish skin, or changes in consciousness, and call EMS for advanced care.

Leaving the wound uncovered would risk air entry and contamination. A loose dressing or a dressing without occlusion won’t prevent air from entering or accumulating, and a simple pressure bandage without any venting doesn’t address the chest wound properly.