What is the correct chest wound management to prevent tension pneumothorax?

• A. Apply an occlusive dressing sealed on three sides to allow air to escape; avoid fully occlusive seals on all four sides
• B. Apply a fully occlusive dressing sealed on all four sides
• C. Leave the wound open to air
• D. Cover with dry gauze only

Answer: (A)

The key idea is preventing air from being drawn into the chest cavity while still allowing any built-up air to escape. An open chest wound can become life-threatening if air enters and becomes trapped, creating a tension pneumothorax. A dressing sealed on three sides acts like a flutter valve: it seals the wound on three sides so external air can’t easily get in, but the open side lets air escape from inside the chest as you breathe out. This reduces the risk of pressure building up inside the chest without creating a perfect airtight seal that could trap air. Fully sealing on all four sides can trap air and raise intrathoracic pressure, increasing the danger of tension pneumothorax. Leaving the wound completely open or covering with just dry gauze doesn’t provide the protective seal needed to prevent air entry and contamination. So, three-sided occlusion best balances preventing air entry with venting built-up air.