First aid to suction the chest wound.

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A chest suction wound is an opening in the chest, from a gunshot wound , stab wound, or other stab wound, that creates a new path for air to enter the chest cavity.

When the chest cavity is expanded for inhalation, air not only enters through the mouth and nose as usual, but also enters through the opening.

Suction wounds to the chest are dangerous because they cause the lungs to collapse ( pneumothorax ). To heal a suction wound on the chest, you need two things: keep the air out of the body while letting the extra air out .

Tashi-Delek / Getty Images

Diagnostics

It can be difficult to tell when a penetrating chest wound is sucking in air or not. They don't always make noise.

Imagine that any penetrating chest wound is a chest wound, whether you hear the hiss or not.

Stages of treatment

If you are with someone who may have a suction injury to the chest, quick action is essential.

Call 911

Call 911 immediately. If the operator gives you instructions, follow them and ignore the rest of this page.

If 911 is not available, get the person to the emergency room as soon as possible. If you are waiting for help to arrive, you may be able to assist them on the spot.

Close the chest wound

Cover the hole with some plastic (preferably sterile or at least clean) and tape on three sides.

You can use a first aid device called a chest seal or improvise with a package that includes a sterile bandage. Open the package and seal the entire plastic part of the wound.

Take care of your sleeping lung

Look for signs of a collapsed lung, also called a tension pneumothorax.

In tension pneumothorax, the collapse of the lung allows a lot of air to pass between the chest wall and the lung, creating pressure. If the pressure is too high, the victim will develop dangerously low blood pressure ( shock ) and most likely die .

Signs of a stretch pneumothorax include:

  • Severe shortness of breath
  • Uneven breasts (one side appears larger than the other)
  • Swelling of the veins in the neck (jugular vein swelling).
  • Blue lips, neck, or fingers ( cyanosis )
  • No lung sounds on one side

If you suspect a tension pneumothorax is growing, remove the padding to allow air to escape.

Important points

Sticking the seal on three sides is supposed to allow air to escape and no air to be sucked in. It doesn't work that well in my experience. Blood tends to stick plastic to the wound.

Close observation works much better than makeshift breast fillings. Just watch for signs of pneumothorax and remove the padding if necessary. There are chest seals made specifically to absorb chest wounds, but nothing beats close observation.

If you need to remove the chest padding to remove the tension pneumothorax, you should probably keep it. Removing the seal will likely release the pressure and equalize the pressure inside the hood with the atmosphere outside.

Again, watch the patient closely for signs of a tension pneumothorax. Recognizing one is difficult if you are not trained in first aid .

If you have a patient with any type of penetrating chest injury (industrial accident, gunshot wound, stab wound, etc.), the most important step is to obtain professional emergency medical attention.

Feel free to call 911 or get the person to the emergency room as soon as possible.

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