How should a sucking chest wound be dressed to prevent tension pneumothorax?

• A. Occlusive dressing sealed on all four sides
• B. Dressing with air vent to allow air in
• C. Airtight dressing without seal
• D. Airtight dressing sealed on three sides

Answer: (D)

Open chest wounds can trap air in the pleural space and lead to tension pneumothorax if air is drawn in with each breath. The best dressing blocks air from entering the chest while still allowing any built-up air to escape. An airtight cover taped down on three sides around the wound achieves this: seal three sides and leave one edge open to vent. This creates a one-way valve effect—air can escape if pressure rises, but external air cannot be forced into the chest during inspiration. Sealing on all four sides would trap air and worsen or precipitate tension pneumothorax; an opening that lets air in defeats the purpose; an insufficiently sealed dressing won’t prevent air entry. Therefore, the three-sides sealed, airtight dressing is the correct approach.