Nov 3, 2018

The Care Of A Sucking Chest Wound

By Barbara Green


There are different patterns of injury that can encountered after trauma. A sucking chest wound is a form of injury that results from a penetrating chest wound. Signs that you should look out for include, evidence of a wound, respiratory distress, foaming around the injured area, coughing of blood and a hissing sound when the individual is breathing in and out. However, some of them may be silent.

If you suspect that someone has suffered this kind of injury, ensure you call the emergency response team immediately. Call for help from anyone else that may be nearby. There emergency phone operator will often guide through on what to do. If they do not, then you will need to do a number of things as you wait.

As is the case for any emergency, always ensure your own safety first. Before attending to the injured, wash your hands and put on a pair of gloves. Inspect the wound and look for any loose clothing or loosely hanging objects. Remove these carefully. Objects that appear to be stuck onto the area should not be extracted by force. Doing so is likely to worsen the injury and reduce the chances of survival.

The objective is to make sure that no more air gets sucked in. All the open wounds should be sealed by use of tape. If a tape is not available then any air right material such as plastic strip can be used. The palm of the hand can be used as a last resort if there is no other option.

The complications resulting from this form of injury vary depending on the exact site injured. Deep injuries are likely to have the lungs involved and may lead to a potentially fatal complication known as tension pneumothorax. In this condition, air leaks from the lungs and builds up within the chest causing excess pressure on other organs such as the heart and major blood vessels.

If you notice the patient having increasing difficulties in breathing associated with crackling sounds under the skin and engorged veins in the neck region, open the seal. This is highly suggestive of tension pneumothorax. The build up of pressure needs to be relieved immediately. If the patient loses consciousness and stops breathing you need to start cardiopulmonary resuscitation, CPR, as you wait for help.

It is important that the patient be taken to hospital as soon as possible. Apart from being stabilized with oxygen therapy, they will require operative management aimed at releasing the air that has been sucked in. This is usually achieved by fixation of a drainage tube that is continuous with an under water seal. This drain may be retained for a few days.

Fortunately if treatment is undertaken promptly, there is good chance of recovery. In case of delays, however, death is almost certain. One may require a week or two to be discharged from hospital or a little longer if they sustained other injuries as well. Full recovery requires a couple of months.




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