Open Chest Wound:

S/S of an Open Chest Wound:

Sucking or hissing sounds coming from

chest wound.
Blood coughed up.
Frothy blood.
Shortness of breath or difficulty in
breathing.

 Chest not rising normally when the

casualty inhales.
Pain in the shoulder or chest area which

increases with breathing.

Bluish tint of lips, inside of mouth,

fingertips, or nail beds.

Rapid and weak heartbeat.

Locate and expose open chest wound:

Expose the area around the open chest

wound by removing, cutting or tearing

the clothing covering the wound. If
clothing is stuck to the wound, do not try
to remove the stuck clothing as this
may cause additional pain and injury.
Cut or tear around the stuck clothing.

 Do not try to clean the wound or

remove objects from the wound.

Check for entry and exit wounds, Look

for a pool of blood under the casualtys

back and use your hand to feel for
wounds.
If there is more than one open chest

wound, treat the more serious wound

first.

Warning: If you are in the chemical

environment, seal and dress the wound(s)

without exposing the wound(s).

SEAL and DRESS:

Since air can pass through a dressing, you

must seal an open chest wound to stop air

from entering the chest and collapsing the
lung.
Open field dressing wrapper.
> Tear open one end of the plastic wrapper of
a field dressing. Remove the inner packet
and put it aside. Continue to tear around the
edges of the plastic wrapper until a flat
surface is created.

 This plastic wrapper will be used to make an

airtight seal which will keep air from entering

the chest cavity through the wound.
If there is both an entry wound and an exit

wound, the plastic wrapper can be torn to

make two seals if the wounds are not too large.
The edges of the sealing material should

extend at least two inches beyond the edges of

the wound.

Sealing and Dressing an Open Chest Wound:

Caution: Avoid touching the inside surface of

the plastic wrapper. The inner surface will be
the applied directly to the wound and should
be kept as free from contamination as
possible.

 Have the casualty exhale. (breathe out).

> If the casualty is unconscious or cannot hold

his breath, place the wrapper over the wound
after his chest falls but before it rises.
Place the wrapper over the wound.
Tape wrapper in place.
Apply field dressing.
Apply manual pressure.

Position the casualty with an open chest

wound:
Position the casualty on his side with

his injured side next to the ground.

Pressure from contact with the ground
acts somewhat like a splint to the
injured sided and helps to reduced
pain.

 The casualty may wish to sit up. If he can

breath easier when sitting up than lying on his

side, allow him to sit up with his back leaning
against a tree, wall or other support. If he
tires, have him lie on his injured side again.

POSITION A CASUALTY WITH AN OPEN CHEST WOUND

Monitor a casualty:
Seek medical help.
Monitor the casualty breathing.
Treat for shock.
Evacuate the casualty ASAP.

WARNING:
Air may still enter the chest cavity even if the

wound is sealed and dressed. The air can

cause a life-threatening condition called
tension pneumothorax.

 If the casualtys condition worsens (increased

difficulty in breathing, shortness of breath,

bluish tint to skin), lift the seal material from
the wound to let the air escape during
complete expiration; then reseal the wound.
Taping the plastic wrapper (flutter valve
effect) helps to prevent tension
pneumothorax.

End. . .