A sucking chest wound is an open chest injury that penetrates the pleural space and draws air during inhalation. What is the recommended dressing?

• A. Open chest injury penetrating pleural space; cover with three-sided occlusive dressing
• B. Simple closed rib fracture
• C. Pulmonary contusion
• D. Esophageal rupture

Answer: (A)

The main point is that a sucking chest wound creates an open path into the pleural space, so air can rush in with each breath and raise the risk of a tension pneumothorax. The best dressing is a three-sided occlusive dressing. By sealing the wound on three sides, it acts like a valve: air can escape if pressure builds during exhalation, but it’s hard for air to be sucked back into the chest during inhalation. This prevents air from being trapped while still allowing ventilation. A completely airtight four-sided seal could worsen air trapping. The other injuries listed don’t involve an open chest wound that communicates with the pleural space, so they don’t require this dressing.