In managing a sucking chest wound (open chest wound), which sequence of actions is recommended?

• A. Occlusive dressing, tape three sides leaving gravity side open, auscultate, burp the dressing if lung sounds are absent
• B. Tape three sides leaving gravity side open, occlusive dressing, auscultate, burp the dressing if lung sounds are absent
• C. Auscultate, occlusive dressing, tape three sides leaving gravity side open, burp the dressing if lung sounds are absent
• D. Occlusive dressing, auscultate, tape three sides leaving gravity side open, burp the dressing if lung sounds are absent

Answer: (A)

In managing a sucking chest wound, the priority is to prevent air from being drawn into the chest while still allowing trapped air to escape. Start by applying an occlusive dressing directly over the wound to seal it. Then secure the dressing on three sides, leaving the edge on the gravity side unsealed so air can escape with each breath. After sealing, assess ventilation by auscultating and observing chest movement to determine whether air is reaching the affected lung. If lung sounds are absent or markedly diminished, gently lift the gravity-side edge to burp the dressing and vent any trapped air. Keep monitoring and transport as needed.