Why two pieces of vented chest seals are required in a bullet wound trauma kit ?

Updated: Nov 9, 2021

Two pieces of vented chest seals are important that must be included in a bullet or wound trauma kit. This is due to the benefits they offer in treating multiple gunshots wounds and providing firm binding that prevents air from entering the chest cavity during inhalation.

This article takes a detailed look at why two pieces of vented chest seals are important and why they must be included in a bullet wound trauma kit.

What are chest seals?

Also known as occlusive dressings, chest seals are used for open chest injuries.

An open chest injury involves the penetration of the chest wall through a gunshot wound or knife. It leaves the chest cavity exposed to air pressure from the atmosphere.

When air enters the chest cavity, it collapses the lungs located around the injured side. However, the chest seal comes in handy at this time. It helps to prevent air from entering the chest cavity during inhalation.



What is the purpose of a vented chest seal?

The vented chest seal, aside from occluding air, also vents out excess air in the chest cavity. This stops the development of Tension Pneumothorax, a life-threatening condition that occurs after pneumothorax. In other words, a vented chest seal is used to treat open chest wounds to relieve pressure in the chest (pneumothorax) or bodily fluid (hemothorax).





Differences between vented chest seal and non-vented chest seals

There are so many differences between the vented and non-vented chest seals. Let's take a look at some of them

  • The non-vented chest seals can be used in managing penetrative chest injuries, especially those located in the thorax and deep wounds in the neck, chest, abdomen, carotid arteries, and jugular vein cuts. While the vented chest seals are specifically designed for treating injured lungs.

  • Vented chest seals quickly stick to the patient's wound regardless of the sweat, hair, blood, and any other debris that might try to obstruct its application. The other side of the seal contains a one-way air vent, although some are just smooth surfaces. Vented chest seals also prevent Tension Pneumothorax (TP), which occurs when a non-vented chest seal is left in an open chest wound for a long time.

  • Unvented chest seals only provide immediate relief, while vented chest seals suck out excess air from the chest cavity and, as a result, prevent TP from occurring.

  • Both vented and unvented chest seals help in breathing and blood oxygenation, but vented chest seals prevent respiratory arrest and hypoxemia.

Types of chest gunshot wounds

Chest gunshot wounds can cause damage to the heart, esophagus, ribs, lungs, or major blood vessels. Most times, a bullet travels straight and so affects a single organ or tissue.

But if it hits a bone, it shatters it and continues on its path, or it deflects and hits another organ in the body.

The major types of chest gunshot wounds include:

Penetrating gunshots wounds

Here the bullet enters the body and remains there for a long while. This is in contrast to the perforating bullet wound, which has an entry and exit point.

Perforating gunshot wounds

In a perforating gunshot wound, the patient will have both an entry and exit wound. These wounds significantly differ. You can find an entrance wound with an abrasion ring, where the skin in the wound area is irritated and reddish-brown. Only small amounts of blood can escape through this wound. The exit wound is much larger and has no abrasion ring. Here, the tissue of the body extrudes through it, and more blood escapes through it.

Other types of bullet wounds include the re-entry wound and the graze wound. The re-entry wound can be problematic because the bullet passes through the body and re-enters again. On the other hand, a grazing wound occurs when the shell brushes the skin and produces a grazing wound.


Why do we prefer two vented chest seals for open chest wounds?

Two vented chest seals are used for open chest wounds. It has a seal used in treating multiple gunshot wounds, including the entry and exit wounds.

The package comes with three vented channels that prevent air from penetrating the chest cavity during inhalation and removes excess air from the chest cavity during expiration. In other words, it does the work of both a vented and unvented chest seal.

Furthermore, two vented chest seals contain an entire package needed to treat open chest wounds in emergencies. The seal's adhesive is superior, providing a firm binding even if the victim is extra sweaty or hairy. There is a gauze pad to clean the wound surface. It is also designed to allow blood escape to reduce blood clotting, which could lead to TP.


How to use the two vented chest seals

Using the two vented chest seals does not involve a difficult process, but there are so many intricacies that can only be carried out by an expert. Here is a detailed step on how to use the two vented chest seals.

  • Check between the belly button and chin of the victim for a penetrating bleeding wound.

  • Ensure to check if there is also an exit wound, which should be lined up with the entry wound.

  • When the wound is found, immediately place a gloved hand over it.

  • Remove the seal from the package. Ensure not to remove the seal’s plastic backing.

  • Wipe off any blood, dirt, sweat away from the site of the wound.

  • Remove your gloved hand covering the wound only when cleaning. Place it back over the wound immediately after cleaning.

  • Put the seal close to the wound and remove the plastic backing slowly while rolling the seal's sticky side over the wound.

  • Ensure that the seal is placed at the center of the wound.

  • Ensure that the seal is stuck to the chest. The vent ports should not be covered with dirt or anything else. It would be difficult for excess air to escape if the vent ports are covered.

  • Repeat the process if there is any other additional wound. If there is an exit wound, ensure to seal it also.


Conclusion

Two vented chest seals are important kits that must be inserted in a gunshot wound kit. The seal is used in treating multiple gunshot wounds, it has superior adhesives that provide firm binding to prevent air from entering the chest cavity during inhalation. One for exit wound, one for extry wound.

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