Open Pneumothorax

An open pneumothorax is defined as an opening in the chest wall that results from a penetrating chest wound. Normally, during the process of respiration, air passes through the trachea during inspiration and expiration. But when a wound at least two thirds the size of the trachea, and sometimes even smaller, air will prefer to pass through the hole in the chest wall. This is due to the decreased resistance to flow. Also, when the victim inhales, the chest will expand as it normally does in normal respiratory cycle, however, air remains outside the lung and in the pleural space.  As a result, there becomes inadequate oxygenation and ventilation. Air will also build up in the pleural space. An open pneumothorax may easily develop into a tension pneumothorax if a flap is made that permits air to enter but not to exit. It may also cause the lung to collapse. An open pneumothorax is also called a sucking chest wound.

Causes of Open Pneumothorax

An open pneumothorax is caused by a penetrating chest wound, especially those acquired at close range.  One can get an open chest wound by any of the following:

  • Stab wounds
  • Gunshot wounds
  • Bite wounds
  • Blast injuries and/ or other penetrating foreign bodies, such as shrapnel

Signs and Symptoms of Open Pneumothorax

Because the open pneumothorax affects the chest, the main signs and symptoms are observed in the chest cavity and are related to breathing. The following signs and symptoms are usually observed in cases of open pneumothorax:

  • An open wound in the chest area
  • Bloody froth coming from the wound, especially when the victim exhales (bubbling appearance)
  • A sucking sound coming from the wound site, especially when the victim inhales
  • Rapid, shallow and difficulty breathing
  • Decreased breath sounds
  • Chest pain
It is necessary to check for breathing all victims of pneumothorax

It is necessary to check for breathing all victims of pneumothorax

First Aid Management for Open Pneumothorax

If one is unsure on the type of pneumothorax a victim is experiencing, it is important to treat all open chest wounds as an open pneumothorax to prevent any complications from occurring. The following should be done to give first aid management for open pneumothorax:

  • Apply sterile occlusive dressing to the wound. Dressing should also be nonporous. To do this, apply a tape dressing on only three of the four sides allowing air to escape from the pleural cavity but not reenter. This is called a Valve effect. One can make use of a plastic wrapping.
  • If one is trained to place a chest tube, do so. This is the primary management for an open chest wound. The wound should not be completely occluded until the chest tube is in place.

An open pneumothorax, or sucking chest wound, is caused by a penetrating chest wound. It is considered a medical emergency. To learn more about how to give first aid treatment to an open pneumothorax, enroll in First Aid and CPR Courses.

Online Sources

http://armymedical.tpub.com/MD0569/MD05690016.htm

http://www.trauma.org/archive/thoracic/CHESTopen.html

http://www.fpnotebook.com/lung/er/OpnPnmthrx.htm

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