Friday, November 2, 2018

Basics Relating To The Handling 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.

Put in place measures that will stop further sucking of air. All the open wounds are to be sealed using tape (including the entry and exit wounds in case of gun shot wounds). If tape is not immediately available then consider any piece of plastic that can create an air right seal.

Depending on the nature of the injury, there may be a number of complications noted immediately or later. If the lung is punctured, there is a high risk of a condition known as tension pneumothorax. The underlying problem here is the escape of air from the lungs and entrapment within the chest cavity. The resultant pressure impedes circulation and may cause death.

Look out for an increasing level of respiratory distress. This is often manifested by rapid shallow breaths. There may be associated enforcement of neck pains and crackles under the skin. All these are highly suggestive of tension pneumothorax and mean that the seal should be opened so as to relieve the pressure. If the patient ceases to breath and their stops beating, there is a need to initiate cardiopulmonary resuscitation as you wait on the emergency response team.

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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