SIGNS AND SYMPTOMS OF AN OPEN CHEST WOUND
An open chest wound can be caused by the chest wall being penetrated by a
bullet, knife blade, shrapnel, or other object. If you are not sure if the wound has
penetrated the chest wall completely, treat the wound as though it were an open chest
wound. Some of the signs and symptoms of an open chest wound are given below.
a. Sucking or hissing sounds coming from chest wound. (When a casualty with
an open chest wound breathes, air goes in and out of the wound. This air sometimes
causes a "sucking" sound. Because of this distinct sound, an open chest wound is
often called a "sucking chest wound.")
b. Casualty coughing up blood (hemoptysis).
c. Frothy blood coming from the chest wound. (The air going in and out of an
open chest wound causes bubbles in the blood coming from the wound.)
d. Shortness of breath or difficulty in breathing.
e. Chest not rising normally when the casualty inhales. (The casualty may have
several fractured ribs, resulting in a flail chest.)
f. Pain in the shoulder or chest area that increases with breathing.
g. Bluish tint of lips, inside of mouth, fingertips, or nail beds (cyanosis). (This
color change is caused by the decreased amount of oxygen in the blood.)
h. Signs of shock such as a rapid and weak heartbeat.
CHECKING FOR OPEN CHEST WOUNDS
Check for both entry and exit wounds. Look for a pool of blood under the
casualty's back and use your hand to feel for wounds.
a. If there is more than one open chest wound, treat the more serious (largest,
b. If there is more than one wound to a side, such as an entrance and exit
wound, apply the flutter valve seal to the wound on the casualty's front and a full seal
(all four sides taped down) to the wound on the casualty's back..
EXPOSING THE WOUND
Expose the area around the open chest wound by removing, cutting, or tearing
the clothing covering the wound. If clothing is stuck to the wound, do not try to remove