In chest trauma, what is the recommended management for an open chest wound?

In chest trauma, what is the recommended management for an open chest wound?

• A. Cover open chest wound with three-sided occlusive dressing; release dressing if tension pneumothorax develops; chest seal PRN
• B. Apply a dry dressing only
• C. Leave wound uncovered
• D. Apply a tourniquet over the chest

Answer: (A)

The key idea is sealing the chest wound to prevent air from entering the pleural space while still allowing trapped air to escape if pressure builds. This is done with a sterile occlusive dressing placed so it is sealed on three sides, which stops air from being sucked into the wound but lets any accumulating air escape. If signs of tension pneumothorax appear, you can loosen the dressing on one side to relieve the pressure, then reapply a proper seal or chest seal as available. Leaving the wound uncovered, using a dry dressing alone, or applying a tourniquet over the chest do not address the risk of air entry and are not appropriate management.

The key idea is sealing the chest wound to prevent air from entering the pleural space while still allowing trapped air to escape if pressure builds. This is done with a sterile occlusive dressing placed so it is sealed on three sides, which stops air from being sucked into the wound but lets any accumulating air escape. If signs of tension pneumothorax appear, you can loosen the dressing on one side to relieve the pressure, then reapply a proper seal or chest seal as available. Leaving the wound uncovered, using a dry dressing alone, or applying a tourniquet over the chest do not address the risk of air entry and are not appropriate management.