h. Chest not rising normally during inhalation.
i. Pain in the shoulder or chest area. The pain usually increases with
j. Bluish tint (cyanosis) of the lips, inside of the mouth, the fingertips, or nail
beds. This color change is caused by the decreased amount of oxygen in the blood.
EXPOSE THE OPEN CHEST WOUND
These treatments are conducted during the tactical field care phase.
Expose the area around the open chest wound by removing, unfastening,
cutting, or tearing the clothing covering the wound. Do not disrupt the wound any
more than is necessary. Do not try to clean the wound or remove debris from the
a. Chemical Environment. If you are in a chemical environment, make sure
the casualty remains masked. Do not remove the casualty's protective clothing. Cut
the casualty's protective clothing (if necessary) to expose the wound, apply sealing
material to the wound, apply a dressing (tails go on outside the protective clothing),
and repair the protective clothing as quickly as possible. Evacuate the casualty as
soon as possible.
b. Stuck Material. If clothing or other material is stuck to the wound area, do
not remove the stuck material since removing it might cause additional damage to the
wound. Cut around the material so the seal and dressing can be applied on top of the
c. Protruding Object. If an impaled object is protruding from the wound, do
not remove the object.
CHECK FOR OTHER OPEN CHEST WOUNDS
Check for an exit wound. Look for a pool of blood under the casualty's back.
Carefully palpate and visually examine the casualty's chest, back, and axillary
(armpits) for other open chest wounds. Remove clothing, as needed, to expose other
wounds if you are not in a chemical environment. If there is more than one open chest
wound, treat the most serious (largest or heaviest bleeding) wound first. Then seal
and dress the other open chest wounds. Any wound from the chin to the umbilicus
(navel) has the potential to enter the chest cavity and requires the use of an occlusive