A chest seal is a specialized medical device designed to manage specific types of penetrating chest injuries. Its primary purpose is to create an airtight barrier over a wound, which helps restore normal pressure dynamics within the chest cavity. This temporary measure provides immediate support in emergencies until professional medical care can be obtained.
Understanding Open Chest Wounds
An open chest wound, often called a “sucking chest wound” or open pneumothorax, occurs when an injury penetrates the chest wall, creating a direct pathway between the outside environment and the pleural space. Normally, the chest cavity operates as a closed system, where pressure changes during breathing allow lung expansion and contraction. When a hole is present, air can be drawn into this space with each inhalation instead of entering the lungs through the airway. This disrupts natural breathing, preventing the affected lung from fully inflating and potentially leading to its collapse. Such an injury can often be identified by a characteristic sucking or hissing sound as air moves in and out of the wound.
How a Chest Seal Works
A chest seal functions as an occlusive dressing, forming a sealed barrier over the wound to prevent external air from entering the chest cavity. Many modern chest seals incorporate a one-way valve system, allowing trapped air and fluids to escape during exhalation. This design ensures internal pressure can be relieved, while preventing additional outside air from being drawn back into the chest during inhalation. By sealing the wound, the chest seal helps re-establish the pressure gradient necessary for proper lung inflation, directing inhaled air back into the trachea and lungs.
Applying a Chest Seal
Applying a chest seal promptly impacts the outcome of an open chest wound. First, expose the injury and quickly wipe away blood or fluids from the surrounding skin to ensure proper adhesion. Once the area is clean and dry, peel the backing from the chest seal to expose its adhesive surface. Center the seal directly over the wound and press firmly onto the skin, ensuring all edges are securely adhered to create an airtight barrier. Also, check for any potential exit wounds, such as from a gunshot injury, and apply a separate chest seal to each opening.
Why Rapid Action Matters
Immediate action in treating an open chest wound is important due to the risk of developing tension pneumothorax. This occurs if air continues to enter the chest cavity but cannot escape, causing pressure to build up around the lung. The increasing pressure can compress the injured lung, heart, and major blood vessels, leading to reduced oxygenation and circulation throughout the body. If left untreated, tension pneumothorax can rapidly lead to respiratory failure, shock, or cardiac arrest.