An open chest wound can lead to the development of tension pneumothorax. Tension pneumothorax is the second leading cause of preventable trauma deaths on the battlefield. It is the progressive build-up of air within the pleural space between the lung and the chest wall.
As the air in the pleural space builds up, the pressure in the space increases and begins to collapse the lung on the injured side. This results in less air that can be exchanged for perfusion in the lung. Once the lung has collapsed, pressure begins to compress the heart, shifting the mediastinum (membrane between the lungs) toward the uninjured side. This shift is known as mediastinal shift.
The development period for a tension pneumothorax can vary. It’s 100% fatal if not treated. The only treatment when it occurs is a needle thoracostomy (needle decompression) performed by skilled medical personnel.
Occlusive Dressings
Laypersons can treat penetrating chest injuries (sucking chest wounds) by the application of an occlusive dressing. These chest seals may slow the development of tension pneumothorax and allow for better breathing. All penetrating chest wounds need to be treated. They are used on any penetrating injuries from collarbone to naval (belly button) on all four sides of the thorax.
