What Are Common Mistakes When Treating Chest Wounds?

Improper Airway Management

Establishing an open airway is crucial when treating a chest wound. The victim’s airway must be assessed and cleared of any debris or blood. If the wound is sucking air, a non-invasive airway management technique such as a chin tuck or jaw thrust may be used to help keep the airway open. If the wound is severe, a surgical airway may be required. In a wilderness setting, a nasopharyngeal airway or oral pharyngeal airway may be used as a temporary measure.

Incorrect Application of a Chest Seal

A chest seal is used to cover the wound and prevent air from entering the chest cavity. However, applying the seal too tightly can exacerbate the problem by increasing the pressure inside the chest. The seal should be applied firmly but not too tightly, and the edges should be sealed with medical tape or a chest seal device. In a wilderness setting, a occlusive dressing such as petroleum jelly or a plastic bag may be used as a temporary measure.

Recognizing Tension Pneumothorax

Tension pneumothorax is a life-threatening condition that requires immediate attention. Signs include severe respiratory distress, decreased or absent breath sounds on one side of the chest, and a shift of the mediastinum away from the affected side. If a tension pneumothorax is suspected, a needle decompression should be performed in the second intercostal space in the mid-clavicular line on the affected side. A chest tube insertion may be required in a hospital setting.