Penetrating Chest Injury / Sucking Chest

Wound Treatment Guidance

Introduction
Following queries from Approved Training Centres (ATC) regarding the
treatment of a penetrating chest injury / sucking chest wound, STA has
produced the following guidance to support tutors and learners in how to
perform the procedure.
Expert opinion recommends leaving the wound open and NOT covering it with an airtight dressing or
even a dressing ‘tapped on 3 sides.’ This is because many dressings inadvertently become occlusive.
First aiders should leave the wound open to fresh air, so not covering the wound with a dressing but
apply direct pressure to stop the bleeding without blocking the hole.

Treatment
999 / 112 should be contacted for further medical assistance.
If the casualty is unconscious, the first aider should open the airway and check for breathing, performing
CPR if necessary. If the casualty is unconscious and breathing, they can be placed in the recovery
position with the injured side lowest to the floor, as this may help protect the uninjured lung.
If the casualty is conscious, they can be sat upright leaning towards the injured side, to help with
breathing.
The wound should be left open to fresh air if possible, to allow air to escape to prevent tension
pneumothorax. Therefore, the first aider should not cover the wound with a dressing. If the wound is
bleeding, direct pressure should be applied around the wound without blocking the hole. This can done
by the first aider using their fingers to seal the edge of the wound and applying pressure, this way they
are not covering the hole.

Penetrating Chest Injury Sucking Chest Wound Treatment Guidance v20.1

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