and organs. T e Tension Pneumothorax is treated in a similar fashion as the movie. A needle is introduced into the airspace to vent off the air, letting the lung and organs return to proper function. T e other injury of concern is a collapsed lung. T is is also called a ‘sucking chest wound.’ T e sucking chest wound occurs when a large enough hole is created in the chest wall for air to more easily enter that hole than the three on your face. You need a hole about 66 percent larger than the diam- eter of your trachea (windpipe); for grown-
ups that means a hole bigger than a penny. If this happens, nature takes the path of least resistance and air enters the space be- tween lung and chest wall, peeling the lung from the chest wall. You may hear hissing or see bubbling and gurgling at the injury site. T is is addressed by a three-sided dressing. T e dressing (plastic bags, etc. and tape on three sides) lets air out, but not air back in. Both injuries need defi nitive medical care to correct the problem. T is is not some- thing that can be done in the fi eld. T e suck- ing chest wound can at least be minimized in the fi eld with readily available material. T e Tension Pneumothorax takes a bit more training to manage, and if done incorrectly can have horrible complications including accelerated death. Randomly stabbing into the chest isn’t recommended in any case. T e good news? T ey are fairly rare in the
fi eld. Recognizing them and passing that information to dispatch and EMS can go a long way in survival of these injuries. If you want to step up your game to treat them more eff ectively, that takes some dedicated training and practice.
Andrew Hamilton is a career Firefighter/ Paramedic/Arson Investigator with 27 years in the fire service, and 14 years in law enforcement/SWAT in multiple roles from SWAT Medic to Entry Team. Currently he is a Patrolman/Armorer/Rangemaster for a small police department and assigned as an Air Rescue Specialist/Critical Care Paramedic with a law-enforcement helicopter service.
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