What is the recommended treatment for a sucking chest wound?

• A. Apply a simple dressing with no seal.
• B. Apply an occlusive dressing and seal on three sides to vent; monitor for signs of tension; adjust as needed and call EMS.
• C. Leave the wound open to air.
• D. Use a tight dressing on all four sides to prevent venting.

Answer: (B)

A sucking chest wound is treated best by sealing the wound while still giving a pathway for air to escape. Sealing the wound on three sides creates a venting effect: air can be expelled from the chest during exhalation, but air is less able to be drawn into the chest during inhalation. This acts like a flutter valve to prevent air from continually entering the pleural space and causing a tension pneumothorax, which can be life-threatening.

After placing an occlusive dressing and sealing three sides, keep the dressing secured and monitor the patient for signs that a tension pneumothorax is developing, such as increasing distress, breathing difficulty, chest pain, confusion or fainting, low blood pressure, or neck vein swelling. If those signs appear, adjust the dressing as needed and call EMS for further treatment. Avoid fully sealing all four sides, which could trap air and worsen a buildup in the chest, and avoid leaving the wound completely open to air, which would not prevent air entry.