Chest Wound Dressing

Chest Wound Dressing - Combat Life Saver Combat Lesson 5...

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Unformatted text preview: Combat Life Saver Combat Lesson 5 APPLY A DRESSING TO AN OPEN CHEST WOUND Compiled and edited by, 2LT John C. Miller, PA-C Lesson 5 Lesson APPLY A DRESSING TO AN OPEN CHEST WOUND INTRODUCTION If an object punctures the chest wall, permitting air to If enter between the chest wall and the lung, the lung collapses. Any degree of collapse, interferes with the body's ability to expand the lung and absorb oxygen. Even if one lung is collapsing, the other lung may be functioning, assuming that side of the chest is intact. The first aid procedure for a casualty with a penetrating chest wound is to prevent the lung from collapsing any more than it has already by placing an airtight seal over the wound. airtight APPLY A DRESSING TO AN OPEN APPLY CHEST WOUND • TASK Apply a dressing to a casualty with an open chest Apply wound. wound. • CONDITIONS Given a simulated casualty with an open chest Given wound and needed supplies. wound • STANDARD Score a GO on the performance checklist. CHECK FOR SIGNS AND SYMPTOMS OF AN CHECK OPEN CHEST WOUND • Obvious penetration of the chest wall by a bullet, Obvious knife blade, shrapnel, or other object. knife • Sucking sound coming from chest wound. (An open Sucking chest wound is often called a "sucking chest wound.") chest • Frothy blood from chest wound. (Bubbles of blood Frothy are caused by air going in and out of the wound.) are • Blood coughed up. • Shortness of breath or other difficulty in breathing. • Chest not rising normally when the casualty inhales. • Pain in the shoulder or chest area which increases Pain with breathing. with CHECK FOR SIGNS AND SYMPTOMS OF AN CHECK OPEN CHEST WOUND • Bluish tint to lips, inside of mouth, fingertips, or Bluish nailbeds. (The color change is caused by the decreased amount of oxygen in the blood.) decreased • Rapid and weak heartbeat.  When in doubt, treat the wound as an open chest wound. LOCATE AND EXPOSE OPEN CHEST WOUND LOCATE • Check for entry and exit wounds. • Expose the area around the open chest wound by Expose removing, cutting, or tearing the clothing covering the wound. wound.  If clothing is stuck to the wound, cut or tear around the stuck If clothing rather than removing the stuck clothing. clothing  Do not try to clean the wound or remove impaled objects.  If you are in a chemical environment, seal and dress the If wound without exposing the wound, other than the exposure needed to seal the wound. needed LOCATE AND EXPOSE OPEN CHEST WOUND LOCATE • Look for a pool of blood under the casualty's back Look and use your hand to feel for wounds. and • If there is more than one open chest wound, treat the If more serious (largest, heaviest bleeding) wound first. more SEAL AND DRESS THE OPEN CHEST SEAL WOUND • Since air can pass through a dressing, you must seal Since an open chest wound to stop air from entering the chest and collapsing the lung. chest • Open Field Dressing Wrapper • Tear open one end of the plastic wrapper of a field Tear dressing. dressing. • Remove the inner packet. • Tear around the edges of the plastic wrapper until a Tear flat surface is formed. Do not touch the inside surface of the plastic wrapper. of SEAL AND DRESS THE OPEN CHEST SEAL WOUND • Seal the Wound • Tell the casualty to completely exhale and hold his Tell breath. If possible, the casualty should hold his breath until the sealing material has been secured. Having the casualty to exhale forces some of the air out of the chest wound. out  If the casualty is unconscious or cannot hold his breath, If place the wrapper over the wound after his chest falls but before it rises. before SEAL AND DRESS THE OPEN CHEST SEAL WOUND • Place the inside surface of the plastic wrapper (the Place side without printing) directly over the wound. The plastic wrapper makes an airtight seal which keeps air from entering the chest cavity through the wound. Breathing can be resumed. Breathing  If the edges of the wrapper do not extend at least two inches If beyond the edges of the wound, it may not form an airtight seal and may even be sucked into the wound. If the wrapper is too small, use foil, a poncho, cellophane, or similar material as the seal. material  If an object is protruding from the chest wound, place airtight If material around the object and stabilize the object with clean, bulky material and bandage. Do not wrap the bandages around the object. bandages SEAL AND DRESS THE OPEN CHEST SEAL WOUND • Tape the top and both sides of the plastic wrapper to Tape the casualty's chest. Leave the bottom edge untaped to form a flutter-type valve to allow air to escape through the chest wound, but keep air from entering the chest wound. • Apply the Field Dressing • Remove the field dressing from the paper wrapper. • Open the field dressing and place the white pad Open directly over the plastic wrapper. directly SEAL AND DRESS THE OPEN CHEST SEAL WOUND • Hold the dressing in place with one hand or have the Hold casualty hold the dressing in place while you secure it. it. • Grasp one tail, slide it under the casualty, and bring it Grasp back over the dressing. back SEAL AND DRESS THE OPEN CHEST SEAL WOUND • Wrap the other tail around the casualty in the Wrap opposite direction and bring it back over the dressing. opposite • Tighten the tails and tie them with a nonslip knot over Tighten the center of the dressing when the casualty exhales. The bandages should keep the dressing and sealing material from slipping, but should not interfere with breathing. breathing. SEAL AND DRESS THE OPEN CHEST SEAL WOUND  If the casualty is unconscious, tie the knot after his chest If falls. falls.  If an object is protruding from the wound, tie the knot beside If the object, not on it. the  If the sealing material slips while the dressing is being If applied or secured, repeat the procedures. applied • Seal and Dress Other Open Chest Wounds • If both an entry wound and an exit wound are If present, both wounds must be sealed in order to stop the collapse of the lung. the SEAL AND DRESS THE OPEN CHEST SEAL WOUND • Apply Manual Pressure • Apply direct manual pressure over the dressing for 5 Apply to 10 minutes to help control bleeding. to  The casualty can apply the pressure if he is able. POSITION A CASUALTY WITH AN OPEN POSITION CHEST WOUND • Position the casualty on his side with the injured side Position next to the ground. (If the casualty were to lie on his uninjured side, his uninjured lung would not expand as well.) as • If the casualty can breathe easier when sitting up, If allow him to sit with his back against a tree or other support. support. MONITOR A CASUALTY WITH AN OPEN MONITOR CHEST WOUND • • • Treat the casualty for shock. Evacuate the casualty as soon as possible. If the casualty has increased difficulty in breathing, If shortness of breath, or bluish tint to skin, quickly lift the sealing material from the wound, let the air escape with complete expiration, and reseal the wound wound APPLY A DRESSING TO AN OPEN APPLY CHEST WOUND CLOSING Once the casualty reaches a medical treatment Once facility, medical personnel can remove trapped air from the casualty's chest and make the lung fully functional again. functional Questions Questions ...
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This note was uploaded on 01/11/2012 for the course STEP 1 taught by Professor Dr.aslam during the Fall '11 term at Montgomery College.

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