An individual with a hole in the chest whether caused by stabbing, gunshot wound or other puncture wound can create a new pathway for air to travel into the chest once it expands. The hole pulls air inside the trunk cavity which is why it is called as a sucking chest wound.
Sucking chest wounds can be considered dangerous since they can quickly bring about collapsed lungs. Managing a sucking chest wound entails preventing the air from entering the lungs while allowing the additional air out. In most circumstances, it can be difficult to identify when a penetrating wound to the chest is sucking air or not, thus it is best to assume that any penetrating wound to the chest is a sucking chest wound.
- Always stay safe by observing the universal precautions and use personal protective gear and equipment if on hand.
- Call for emergency assistance. If the operator provides instructions, it should be followed. In case emergency assistance is not available, you have to bring the individual to the hospital as soon as possible.
- You have to close off the sucking chest wound. All you have to do is to place something over the wound if possible sterilized or at least clean and secure in place.
- You have to watch out for indications of tension pneumothorax. It is important to note that tension pneumothorax is basically a collapsed lung that leaked out air between the chest wall and the lung, building up pressure and pushing the lungs over to the side of the body. In case pressure builds up excessively, the individual will develop dangerously low blood pressure and will surely die. The indications of tension pneumothorax include shortness of breath, uneven chest, bluish lips, protruding neck veins and absence of lung sounds on one side.
- Remove the seal if needed. Once you suspect that tension pneumothorax is building up, you have to remove the seal to allow the air to escape.
Important tips to bear in mind
You have to seal the wound on three sides. This is supposed to allow the air to escape while blocking air from sucking in. On the other hand, this does not work well since blood has the tendency to adhere the plastic to the wound. Careful monitoring is vital than using the makeshift chest seals. There are plastic seals specifically made for sucking chest wounds but it still requires observation.
If you have to remove the chest seal to relieve tension pneumothorax, you should leave it off. Removing the seal will allow the pressure out and equalize the pressure within the chest with the outside atmosphere. Do not forget to monitor the individual closely for indications of tension pneumothorax.
Determining if the individual has tension pneumothorax is a hard task if the individual has not been trained in first aid. If the individual sustained a penetrating wound to the chest of any kind, the initial step is to seek immediate emergency care. Do not hesitate to call for emergency assistance or bring the individual to the nearest emergency department as quickly as possible.