A 17-year-old male is shot in the right anterior chest. You find an open chest wound with a small amount of frothy blood bubbling. What is the correct immediate action?

A 17-year-old male is shot in the right anterior chest. You find an open chest wound with a small amount of frothy blood bubbling. What is the correct immediate action?

• A. Apply a semi-occlusive dressing to the wound and continue your assessment.
• B. Apply a fully occlusive dressing on the wound.
• C. Do nothing and transport.
• D. Remove the object and compress.

Answer: (A)

In penetrating chest trauma with an open wound and signs of air leak, the priority is to prevent air from being drawn into the chest while still allowing any trapped air to escape. A semi-occlusive dressing over the wound accomplishes this by sealing the wound but staying ventilated on at least one edge, effectively creating a flutter-valve effect. This helps prevent a tension pneumothorax while protecting the wound. Apply the dressing and continue your assessment with rapid transport. Fully occlusive dressings can trap air and worsen a possible pneumothorax, doing nothing isn’t appropriate for an open chest wound, and removing the wound or object isn’t indicated here.

In penetrating chest trauma with an open wound and signs of air leak, the priority is to prevent air from being drawn into the chest while still allowing any trapped air to escape. A semi-occlusive dressing over the wound accomplishes this by sealing the wound but staying ventilated on at least one edge, effectively creating a flutter-valve effect. This helps prevent a tension pneumothorax while protecting the wound. Apply the dressing and continue your assessment with rapid transport. Fully occlusive dressings can trap air and worsen a possible pneumothorax, doing nothing isn’t appropriate for an open chest wound, and removing the wound or object isn’t indicated here.