In open pneumothorax, what is the recommended first-line dressing?

In open pneumothorax, what is the recommended first-line dressing?

• A. Monitor for signs of tension pneumothorax
• B. Administer oxygen and ongoing assessment
• C. Apply vented chest seal/occlusive dressing
• D. Refer for imaging before action

Answer: (C)

Open pneumothorax involves a chest-wall defect that can pull air into the pleural space during inspiration. The first thing to do is seal that wound with an occlusive dressing that is vented if possible. A vented chest seal lets air escape during exhalation, which prevents air from building up in the chest and reduces the risk of progressing to a tension pneumothorax while still protecting the wound from entry of air. Providing oxygen and ongoing assessment are important, but they don’t address the immediate problem of air entering the chest. Delaying to imaging isn’t feasible in the urgent field setting, and waiting without sealing the wound risks worsening collapse of lung function. Therefore, applying a vented chest seal or occlusive dressing is the best first step.

Open pneumothorax involves a chest-wall defect that can pull air into the pleural space during inspiration. The first thing to do is seal that wound with an occlusive dressing that is vented if possible. A vented chest seal lets air escape during exhalation, which prevents air from building up in the chest and reduces the risk of progressing to a tension pneumothorax while still protecting the wound from entry of air. Providing oxygen and ongoing assessment are important, but they don’t address the immediate problem of air entering the chest. Delaying to imaging isn’t feasible in the urgent field setting, and waiting without sealing the wound risks worsening collapse of lung function. Therefore, applying a vented chest seal or occlusive dressing is the best first step.