HWN Suggests

A sucking (and blowing) chest wound is the sound of not dying

Although there is experimental animal literature that vented (compared to non-vented) commercial chest seals do work to prevent an open pneumothorax with ongoing air leak from becoming tension pneumothorax, there still is no clear evidence that an isolated open pneumothorax needs to be sealed.

If you choose to seal chest wounds, use a vented chest seal. If you want to go with the evidence and cut down on medical gear you carry, there just isn’t any compelling evidence penetrating chest injuries involving only one side of your casualty need to be sealed.

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Articles of Interest

Treating Sucking Chest Wounds and Other Traumatic Chest Injuries

When the hole in the chest wall approaches 66% of the width of the trachea, a sucking chest wound can occur.2 The average tracheal width in a male has been reported to be 17.7 ± 2.0 mm in one report and 20.9 ± 0.32 mm in another report. The average tracheal width in females has been reported to be 15.8 ± 1.8 mm in one report and 16.9 ± 0.25 mm in another. An easy way to remember this is that any wound roughly the size of a penny or larger can lead to a sucking chest wound. Patients with a sucking chest wound will present with the same general signs and symptoms common to all pneumothoraxes listed previously. In addition, the patient will have an open wound to the chest that will normally bubble blood with inspiration and expiration.