Prolonged Field Care Podcast Prolonged Field Care Podcast: Chest Trauma
Aug 1, 2025
This discussion dives into the nuances of chest trauma management, emphasizing the critical role of patient assessment and the strategic use of chest seals. The speakers scrutinize the March algorithm, calling for a fresh look based on evolving data. Blood transfusions are highlighted as a key intervention early in care. They detail techniques like needle decompression and finger thoracotomy, advocating for thorough training to ensure effective responses in high-pressure situations. Overall, the conversation underscores the importance of adapting protocols to real-world experiences.
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Don’t Seal Every Chest Wound
- Inspect chest wounds before automatically applying a chest seal; not all bleeding wounds communicate with the pleural space.
- Remove blood, look for bubbling or active sucking, and only apply a seal if the wound communicates with the chest.
Body Compensation Buys Time
- Spontaneously breathing patients often compensate for open chest wounds and usually tolerate delayed sealing.
- Immediate chest sealing is less urgent when the patient is breathing on their own and can wait while you reassess.
Review Seals Before Ventilating
- Reassess all chest seals when the patient goes on positive-pressure ventilation and remove them if decompensation occurs.
- Under positive pressure the chest can trap air and convert an open pneumothorax into a tension, so reconsider dressings promptly.