the stuck clothing as this may cause additional pain and injury. Cut or tear around the
stuck clothing. Do not try to clean the wound or remove objects from the wound.
SEALING AN OPEN CHEST WOUND
Since air can pass through dressings and bandages, you must seal the open
chest wound with plastic, cellophane, or other nonporous, airtight material to prevent air
from entering the chest and collapsing the lung. The wrapper from an emergency
bandage or a field first aid dressing can be used. Foil or material cut from a poncho can
also be used.
If possible, use supplies from the casualty's first aid kit rather than your own.
You may need your supplies in case you have to administer aid to yourself
a. Prepare the Sealing Material. Cut the airtight material as needed so that it
lies flat and will extend at least two inches beyond the edges of the wound (all
b. Have Casualty Exhale. Tell the casualty to exhale (breathe out) and hold his
breath. This forces some of the air out of the chest wound. The more air that can be
forced out of the chest before the wound is sealed, the better the casualty will be able to
breathe after the wound is sealed.
The casualty can resume normal breathing after the wound is sealed.
If the casualty is unconscious or cannot hold his breath, place the sealing
material over the wound after his chest falls but before it rises.
c. Apply and Tape the Airtight Material Over Wound.
(1) Place the cleanest side of the sealing material directly over the wound.
If a plastic bandage wrapper is being used, place the inside surface of the wrapper (the
side without printing) directly over the wound.
(2) Check the material to make sure that it extends at least two inches
beyond the wound edges in all directions. If the material does not have a two-inch
margin, it may not form an airtight seal and may even be sucked into the wound. If the
sealing material is not large enough or is torn, remove it and obtain other airtight
material to form the seal.
(3) Tape down three edges of the material, usually the top edge and two
side edges. This creates a "flutter valve" effect. When the casualty inhales, the plastic
is sucked against the wound and air cannot enter the wound. When the casualty
exhales, air may be able to exit the wound through the untaped (bottom) edge of the
plastic. See figure 4-3.