Key Takeaways
· seals prevent air from entering the chest through puncture wounds, such as those caused by bullets or stabs.
· Apply a chest seal immediately if you notice a deep puncture wound, even if you are unsure whether it is necessary.
· Vented chest seals allow trapped air to escape while preventing additional air from entering the chest.
· Chest seals are essential emergency tools that help prevent life-threatening conditions like pneumothorax. Learning how to use them correctly enables anyone, not just medical professionals, to provide potentially lifesaving aid in critical situations.
The wall of the human chest is made up of muscles, cartilage, and bones, including the ribs, which protect vital organs, airways, and major blood vessels, and help move air in and out of the lungs.
When you breathe, muscles and cartilage around your ribs allow the chest to expand and contract, drawing air into the lungs through the trachea. A puncture in the chest wall, such as from a bullet or stab wound, can disrupt this system.
When the chest wall expands and contracts, air can enter through the wound, putting pressure on the lungs. This condition is called a pneumothorax, or collapsed lung, and it is serious.
A wound that bubbles blood when the person breathes is a sign that air is in the chest and requires immediate treatment. A chest seal does not stop bleeding; instead, it closes the wound to prevent air from entering. Many chest seals have vents to let trapped air escape.
In any first aid situation, start by calling 911, ensuring the area is safe, and wearing protective gloves. Then, assess the person's wounds carefully.
If you suspect a deep chest puncture, applying a chest seal is crucial. Acting quickly helps prevent air from entering the chest. Using a chest seal is safe even if the wound isn’t deep enough for air to enter.
Some injuries, such as gunshot wounds, may have both entry and exit points. Check for an exit wound, and seal both openings to reduce the risk of a pneumothorax.
To apply a chest seal:
1. Prepare the area: Dry the skin as thoroughly as possible; some kits include gauze for this purpose.
2. Prepare the seal: For store-bought seals, remove the backing to expose the adhesive. If making a homemade seal, pre-cut tape or other materials.
3. Apply the seal: Follow the product instructions carefully, placing the seal after the patient exhales to minimize air in the chest.
4. Monitor the patient: Observe breathing and be prepared to “burp” the seal or replace it if needed until emergency personnel arrive.
Chest seals are essential for treating penetrating chest wounds. Here’s an overview of common types and tips for improvised options if a kit isn’t available.
The Halo Chest Seal is one of the first commercially produced chest seals, featuring a simple, no-frills design: a sterile plastic pad with an adhesive backing. To use it:
1. Clean the wound by wiping away blood or dirt so the adhesive sticks properly.
2. Apply the seal directly over the wound.
Because it has no vent, monitor the patient closely. If they develop worsening shortness of breath or drowsiness, air may be trapped inside, potentially causing a pneumothorax. In such cases, gently lift an edge of the seal to “burp” it (release trapped air) or replace it with a fresh seal.
The Asherman chest seal includes a vent that functions as a one-way valve, allowing air to escape but not enter the chest—solving the issue a solid seal like the Halo can present.
To apply:
1. Align the vent with the chest wound.
2. Press the seal firmly around the wound to ensure a secure fit.
While lining up the vent can take extra time, this type of seal is highly effective in preventing tension pneumothorax.
If a commercial chest seal isn’t available, you can improvise one using materials on hand.
A simple method is to use the packaging from a sterile dressing, such as a gauze roll. These packages typically have a paper side and a plastic side, with the inside surfaces remaining sterile—ideal for protecting the wound.
1. Open the package and discard the paper and contents.
2. Place the plastic directly over the chest wound, with the sterile side touching the skin.
3. Secure the edges with tape on all sides to create a seal.
Even with an improvised chest seal, follow the same precautions: monitor the patient for breathing difficulties, and replace or “burp” the seal as needed until medical help arrives.
Will a chest seal stop bleeding?
A chest seal is primarily designed to prevent air from entering the chest cavity. While it may help slow bleeding, it is not intended to fully stop it.
2. What does it mean to burp a chest seal?
“Burping” a chest seal means allowing trapped air to escape from under the seal. Gently lift a corner of the dressing to release air, which can relieve pressure and help the patient breathe more easily.
3. What is an occlusive dressing?
An occlusive dressing is a type of bandage that creates a sealed barrier over a wound, preventing air from passing through. Chest seals are a specialized form of occlusive dressing designed for puncture wounds that risk causing a pneumothorax.
4. When should you use a chest seal?
Chest seals should be used on puncture wounds to the chest wall. If you suspect such an injury while providing first aid, applying a chest seal can prevent a pneumothorax, a potentially life-threatening condition.
