(7) Apply the adhesive dressing (5.5 inches in diameter) over the wound
so that it adheres to the casualty's chest and the one-way valve is over the penetrating
wound. The one-way valve lets air and blood escape while preventing their re-entry.
The clear pad design allows you to visually inspect the wound.
b. Improvised Occlusive Dressing. If you do not have a manufactured seal
available, you can improvise a seal using airtight material, such as the plastic
envelope from a field dressing or a petroleum gauze packet. The following steps give
procedures for sealing an open chest wound using a plastic envelope.
(1) Obtain a field dressing package. If the casualty is carrying a field
dressing, use his dressing. Otherwise, obtain a field dressing from your aid bag.
Open the plastic dressing envelope.
(a) Remove the bandage scissors from your aid bag.
(b) Cut one of the short ends of the plastic envelope and remove the
inner packet (dressing wrapped in paper). Cut the envelope so as little as possible is
cut off the main part of the envelope. Drop or place the inner packet where it will not
become contaminated. You may place the packet on the casualty's abdomen, for
(c) Cut the other short end of the plastic envelope and one of the long
sides. You now have a rectangular piece of airtight plastic which can be used to seal
the open chest wound.
Avoid touching the inside surface of the plastic envelope. The inner
surface will be applied directly to the wound and should be kept as free
Have the casualty exhale.
(a) If the casualty is conscious, tell him to exhale and hold his breath.
This forces some of the trapped air out of the chest cavity. The more air forced out of
the chest cavity before the wound is dressed, the better the casualty will be able to
(b) If the casualty is unconscious or cannot hold his breath, place the
plastic envelope over the wound after his chest falls but before it rises again.