Disclaimer: I am not a medical professional. I have limited experience and limited training in this area. I’d like to have more training. The information I give here is just that, for informational purposes only. For real training, seek competent medical professionals.
I once asked an ER doctor to give some training for a group of people who were interested in some additional first aid training. When he showed up he was very knowledgeable and very helpful, but his limitations in field medicine were obvious. He knew how to care for patients in a hospital setting with almost unlimited personnel and equipment at his disposal. In the field by himself only his knowledge of medicine was his advantage over the average person. We usually have the same supplies and gear. I’m not saying I didn’t learn anything from this obviously talented doctor, but what we needed was a field medic. Doctors and nurses are usually tied to a hospital or office with resources. I don’t fault them, I appreciate their life saving skills, and some of them have some good field experience. But often they can lack the “seat-of-your-pants” medicine that is needed for the field.
While fighting in a battle that never seemed to end in South America we lost some brothers. There were some injuries also and one guy was shot in the chest. We administered first aid and the wound was a “through-and-through”. Our medic put on a chest seal and the bleeding was minimal. He actually did a little fighting until the next day when we could all get out. I was able to help the medic so I got my real world experience in using a chest seal (my one and only experience!) I can remember being trained in doing this and using whatever plastic we had available, even a cigarette pack plastic wrap. I never thought I’d ever have to use any of that training.
A sucking chest wound (SCW) happens when an injury causes a hole to open in your chest. SCWs are often caused by stabbing, gunshots, or other injuries that penetrate the chest.
Signs of an SCW include:
an opening in the chest, about the size of a coin
hissing or sucking sounds when the person inhales and exhales
heavy bleeding from the wound
bright red or pinkish, foaming blood around the wound
coughing up blood
SCWs sometimes make no noise. Treat any wound caused by chest penetration as an SCW.
What should I do to provide immediate first aid?
If an object is still protruding from the wound, don’t remove it. This can make the injury worse.
Call your local emergency services immediately. If no emergency services are available, get the injured person to a hospital as soon as possible. Follow any steps that the emergency services operator gives you. You may be directed to do the following:
1. Sterilize your hands with soap and water.
2. Put on gloves or other hand protection.
3. Remove any loose clothing or objects covering the wound. Don’t remove clothing that’s stuck to the wound.
4. Keep a hand over the wound while preparing a dressing. Protect your hand with a glove or other hand protection. If possible, have someone else put their hand over the wound. If no one else is available, have the injured person cover the wound with their hand if they’re still able to do so.
5. Find a chest seal or sterile, medical-grade plastic, or tape to seal the wound. If you don’t have medical plastic, use a clean Ziploc bag or a credit card for the wound. Use your hands if you have no other option.
6. If possible, ask the person to breathe out to release any excess air.
7. Place tape, plastic, or a chest seal over any hole that’s sucking in air, including entry and exit wounds. Make sure no air enters any wound.
8. Secure the tape or seal with occlusive dressing or similar wrapping material that can create a water and airtight seal. Make sure the seal has at least one open side to let out air without letting air in.
9. Remove the seal if you notice symptoms of tension pneumothorax, or a buildup of air in the chest. This happens when a lung leaks air into the chest and builds pressure. This can cause extremely low blood pressure (shock) and be fatal. Symptoms include crackling sounds when the person breathes in or out (subcutaneous emphysema), lip or finger blueness (cyanosis), enlarged neck veins (jugular vein distention), short, shallow breaths, and one side of the chest appearing larger than the other.
Keep the person on their side unless this makes it harder for them to breathe. Let out as much excess air as possible from the chest while making sure that the person can still breathe.
If the person loses consciousness or stops breathing, do the following:
Perform cardiopulmonary resuscitation (CPR)
use a blanket to keep them from getting too cold
don’t let the person eat or drink
put pressure on wounds to slow bleeding
These are the basics of a SCW. Direction from a qualified doctor, nurse, paramedic, or EMT may be different. Follow the professional’s directions if communication with them is available. Again, seek out training in this area by competent medical professionals. I hope you are never in a situation where you need to use this info, but if you are, you could save someone’s life.
Semper Paratus
Check 6
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