Can an open chest wound cause a tension pneumothorax?

Occasionally, chest wounds occur in an arrangement such that air is able to travel from the environment, through the chest wall and into the pleural space during inhalation, but is unable to escape during exhalation. Since air is trapped during each breath, a tension pneumothorax can develop quickly.

Is tension pneumothorax open or closed?

Pneumothorax (air in the pleural cavity) is classified as open (external wound) or closed. The pleural pressure equilibrates with atmospheric pressure, resulting in lung collapse. Tension pneumothorax develops when air continuously enters the chest without evacuation.

When dressing a penetrating chest wound the dressing is taped on 3 sides Why?

Taping the seal on three sides is supposed to allow air to escape while blocking air from sucking in.

What is the preferred treatment for a tension pneumothorax?

Treatment of tension pneumothorax is immediate needle decompression by inserting a large-bore (eg, 14- or 16-gauge) needle into the 2nd intercostal space in the midclavicular line. Air will usually gush out.

What are the risks of an occlusive dressing for pneumothorax?

The risk of any occlusive dressing is the potential conversion of an open pneumothorax to a tension pneumothorax. Using a vented chest seal decreases that risk.

What are commercial dressings for open chest trauma?

Commercial dressings for open chest trauma have been used with great success by both military and tactical medics, and should be part of a medic’s standard supply. With an open chest wound that is covered, the patient may often still deteriorate and have a tension pneumothorax.

What is the worst-case scenario with an open pneumothorax?

The worst-case scenario with an open pneumothorax is a 100% collapse of that lung. Emergency Physicians routinely take care of patients with spontaneous pneumothoraces and 100% complete collapse of one lung with no significant vital sign abnormalities or significant resting shortness of breath.

Can sucking cause tension pneumothorax?

The sound of sucking & blowing is the sound of not dying of tension pneumothorax. There is no good evidence an open pneumothorax needs to be sealed and you can cause tension. Although the open pneumothorax or “sucking chest wound” is dramatic in appearance, it is rarely fatal.