How should an open chest wound with a sucking sound be managed immediately?

How should an open chest wound with a sucking sound be managed immediately?

• A. Leave wound open to air.
• B. Apply a dry sterile dressing.
• C. Apply an occlusive dressing sealed on three sides.
• D. Cover with a tight plastic wrap.

Answer: (C)

Open chest wounds with a sucking sound indicate an open pneumothorax. The immediate goal is to stop air from being sucked into the chest during inhalation while still allowing air to escape so the lung doesn’t collapse into a tension pneumothorax. Sealing the wound with a dressing that is occlusive on three sides achieves this: it covers the wound and prevents air from entering on inspiration, while the one open edge lets air escape during exhalation. This “three-sided occlusive dressing” is preferred over leaving the wound completely open (air can move in and out freely), using just a dry dressing (which won’t seal), or sealing all four sides (which can trap air and worsen a tension pneumothorax). After applying, monitor the patient closely, provide supportive care, and transport promptly.

Open chest wounds with a sucking sound indicate an open pneumothorax. The immediate goal is to stop air from being sucked into the chest during inhalation while still allowing air to escape so the lung doesn’t collapse into a tension pneumothorax. Sealing the wound with a dressing that is occlusive on three sides achieves this: it covers the wound and prevents air from entering on inspiration, while the one open edge lets air escape during exhalation. This “three-sided occlusive dressing” is preferred over leaving the wound completely open (air can move in and out freely), using just a dry dressing (which won’t seal), or sealing all four sides (which can trap air and worsen a tension pneumothorax). After applying, monitor the patient closely, provide supportive care, and transport promptly.