OPEN/PENETRATING CHEST INJURIES

Overview
A sucking chest wound (SCW) happens when an injury causes a hole to open
in your chest. SCWs are often caused by stabbing, gunshots, or other injuries
that penetrate the chest.

Signs of an SCW include:

 an opening in the chest, about the size of a coin

 hissing or sucking sounds when the person inhales and exhales
 heavy bleeding from the wound
 bright red or pinkish, foaming blood around the wound
 coughing up blood

SCWs sometimes make no noise. Treat any wound caused by chest

penetration as an SCW.

What should I do to provide

immediate first aid?
If an object is still protruding from the wound, don’t remove it. This can make
the injury worse.

Call your local emergency services immediately. If no emergency services are

available, get the injured person to a hospital as soon as possible. Follow any
steps that the emergency services operator gives you. You may be directed to
do the following:

1. Sterilize your hands with soap and water.

2. Put on gloves or other hand protection.
3. Remove any loose clothing or objects covering the wound. Don’t
remove clothing that’s stuck to the wound.
4. Keep a hand over the wound while preparing a dressing. Protect
your hand with a glove or other hand protection. If possible, have
someone else put their hand over the wound. If no one else is available,
have the injured person cover the wound with their hand if they’re still
able to do so.
5. Find a chest seal or sterile, medical-grade plastic, or tape to seal
the wound. If you don’t have medical plastic, use a clean Ziploc bag or
a credit card for the wound. Use your hands if you have no other option.
6. If possible, ask the person to breathe out to release any excess air.
7. Place tape, plastic, or a chest seal over any hole that’s sucking in
air, including entry and exit wounds. Make sure no air enters any
wound.
8. Secure the tape or seal with occlusive dressingor similar wrapping
material that can create a water and airtight seal. Make sure the seal
has at least one open side to let out air without letting air in.
9. Remove the seal if you notice symptoms of tension
pneumothorax, or a buildup of air in the chest. This happens when a
lung leaks air into the chest and builds pressure. This can cause
extremely low blood pressure (shock) and be fatal. Symptoms include
crackling sounds when the person breathes in or out (subcutaneous
emphysema), lip or finger blueness (cyanosis), enlarged neck veins
(jugular vein distention), short, shallow breaths, and one side of the
chest appearing larger than the other.
Keep the person on their side unless this makes it harder for them to breathe.
Let out as much excess air as possible from the chest while making sure that
the person can still breath.

If the person loses consciousness or stops breathing, do the following:

 perform cardiopulmonary resuscitation (CPR)
 use a blanket to keep them from getting too cold
 don’t let the person eat or drink
 put pressure on wounds to slow bleeding

How is this type of wound treated

in a hospital?
Once the person has been admitted into the hospital, the following may be done:

 A facemask is placed over the nose and mouth of the patient to deliver oxygen
into their body.
 The patient is connected to an intravenous (IV) catheter and given anesthesia so
that a doctor or surgeon can operate.
 During surgery, a small incision is made on the patient’s chest. The surgeon
inserts a chest tube into the patient’s chest cavity (the pleural space) to drain
fluids from the area around their lungs. The chest tube stays in until all excess
air and fluid has been drained.
 The surgeon then surgically closes the wound with stitches or sutures to prevent
further bleeding and to keep air from getting into the pleural space.
Are there any possible
complications?
Possible complications of an SCW that can be fatal include:

 tension pneumothorax
 loss of oxygen in the blood (hypoxia)
 shock from blood or oxygen loss (hypotension)
 fluid buildup in the chest cavity
 injuries to vital organs, such as the heart, lungs, or gastrointestinal system
There are 4 Rules of Gun Safety that must be followed 100% of the time. When the
rules are followed accidents can be minimized. Being a gun owner means that you
have made a commitment to knowing these rules and living them. Responsible gun
ownership means learning and practicing behaviors that will help prevent needless
injury, death, and theft.

#1 Treat all guns as if they are always loaded.

An individual who properly inspects and shows a gun to be clear before further
handling is seen as a responsible and knowledgeable participant at the range. Take the
time to treat every firearm that you come in contact with as though it COULD be
loaded. Never assume that someone has handed you an unloaded gun. Take the time
necessary to see safely inspect the firearm yourself before moving on. Never accept
into your possession a firearm that you are unfamiliar thinking that you can fiddle with
it until you figure it out. You will never be wrong to ask for assistance and a
demonstration of safe and correct usage of that firearm.

#2 Never let the muzzle cover anything that you are not willing to destroy.
Situational awareness is critical to firearm safety. Before you make contact with the
firearm consider your environment and determine your safe direction. If you are at an
indoor or outdoor range and are unsure, ask. It is your responsibility to ALWAYS keep
the gun pointed in a safe direction 100% of the time whether you are setting up in your
work area, loading, reloading, shooting, showing clear, or laying the firearm down on
the bench. When walking with or transporting a long gun muzzle is Up or Down and the
firearm is unloaded. If you are unsure about your range’s rules for transportation,
casing/uncasing your firearm in respect to muzzle direction, ask.

#3 Keep your finger off the trigger until your sights are on target and you have made the
decision to shoot.
Trigger finger discipline is a learned skill and is vitally important to maintaining the safe
condition of the firearm at all times. Your “Trigger Finger” must become your “Safety
Finger.” From the moment you make physical contact with the firearm your finger must
be kept straight and rest along the side of the frame. Through all administrative
actions, such as, but not limited to, picking up, loading, reloading, fixing malfunctions,
unloading or resting in various ready positions your finger is in this indexed position
along the frame. Only when it is appropriate to shoot, your sights are on target and you
have made the decision to shoot that you are able to move your finger from it’s
indexed position onto the trigger.

#4 Be sure of your target and what lies beyond it.

You are responsible for everything which a round you shoot comes in contact with. This
means another big dose of situational awareness BEFORE you make the decision to
shoot! Consider the height of your target and the angle at which you will shoot it. If the
round would make an impact through you intended target and impact something other
than a bullet safe berm, trap or safe zone then you are obligated not to take the shot.
This means never point or fire ar anything you can’t clearly identify as a target or that
would be a danger if your bullet strays, ricochets, or over penetrates.

Bonus Rule: Always Secure Your Firearm from Unauthorized Persons.

Store your guns so they are not accessible to unauthorized persons. This includes
friends, children, welcomed guests, or unwelcome visitors, such as criminals in your
home.
The Rules of Firearm Safety are so important that A Girl & A Gun shows them to you all
the time: on your membership card, on its website, on Facebook, etc. We never get
tired of reviewing them and neither will you!