Sucking Chest Wound & Blast Injuries

A sucking chest wound (SCW) happens when an injury causes a hole to open in your chest. SCWs are often caused by stabbing, gunshots, or other injuries that penetrate the chest.

Signs of an SCW include:

  • an opening in the chest, about the size of a coin
  • hissing or sucking sounds when the person inhales and exhales
  • heavy bleeding from the wound
  • bright red or pinkish, foaming blood around the wound
  • coughing up blood
Treatment:
  • D.R.S.A.B.C.D.
  • Call 000 for an ambulance.
  • Cover any entry/exit wounds
  • If an object is embedded in the chest:  LEAVE IT THERE!
    • Apply padding around the object
    • DO NOT apply pressure over the embedded object
  • If the wound is open, cover it with a plastic or non-stick dressing
  • Tape the top and both sides (3 sides) of the dressing. DO NOT tape the bottom of the dressing. This acts as a one-way valve and reduces the air entering through the wound
  • If the casualty is unconscious, place into the recovery position with the affected side down, unless an object is embedded in the casualty
  • Complete the secondary survey and treat any subsequent injuries
  • Monitor signs of life, particularly the casualty’s breathing

NOTE:   If a sucking chest wound is suspected, the casualty needs urgent hospitalisation to reduce the pressure on the lungs and heart.

Blast Injuries

When an explosion occurs, the body is exposed to sudden increases in air pressure which can rupture delicate air sacs that exchange gases, causing bleeding within in the lungs and the patient to be subject to a lack of oxygen.

Other areas of the body, such as the brain, heard and other abdominal organs can also become injured to varying degrees. These injuries may not be immediately seen; however, they can potentially become fatal.

Management

If a casualty has been involved in a blast you should

  • Reassure the casualty.
  • Assist the patient to a position of comfort.
  • Loosen any tight restrictive clothing and keep warm with a blanket, be sure not to overheat.
  • Whilst waiting for assistance monitor the casualty’s vital signs and where possible record every 5-10 minutes.
  • If the casualty becomes unconscious, follow DRSABCD.