Make me smart: Chest seals

Started by majorhavoc, December 17, 2023, 08:32:48 AM

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majorhavoc

Any EMTs, LEO or military medics in the group?  After much deliberation, I've decided I should add chest seals to my group FAK (the one I keep in my car).  I admit that a recent nearby mass shooting (the Lewiston, Maine incident) has convinced me to do this.

Full disclaimer: while I am basic first aid certified, I have no experience or training with the kind of trauma that would indicate the need for a chest seal.  My education consists of YT videos.  I understand that there are two basic kinds: vented and occlusive. I have a vague sense that the vented seal should be applied to the entry wound and the occlusive should be applied to the exit wound (if there is one).  Oh, and the thought of using a decompression needle scares the shit out of me.  That's it.  That's all I know.  

Any advice?  
At my level of training are chest seals even advisable?  
If there's an indication of tension pneumothorax and I'm dicking around with a chest seal, in what ways could I do more harm than good? 
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Z.O.R.G.

It's been a while since I was trained/certified, but I believe you need to be formally trained/certified to use a decompression needle.  Dressings are another matter.  I don't remember any contraindications for applying an occlusive dressing.  There are commercial ones available, but anything clean and airtight will work in a pinch.  If it's not sterile (we were old to use MRE wrappers) the patient is going to get antibiotics at the ER anyways as what caused the wound wasn't sterile.    

Here's some links:

Treating Sucking Chest Wounds and Other Traumatic Chest Injuries - JEMS: EMS, Emergency Medical Services - Training, Paramedic, EMT News

Sucking Chest Wound: First Aid, Treatment, and Recovery (healthline.com)

majorhavoc

Thank you Z.O.R.G. That helps me feel better about using chest seals. And believe me, I am fine forgoing the use of a decompression needle. Like I said: the very thought of attempting to use one scares the shit out of me.

Anyone else? This seems like an important topic.
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12_Gauge_Chimp

I forget the brand name (you can find them at Academy), but I picked up a couple small IFAKs that supposedly the plastic bag they came in can double as a makeshift chest seal.

I wish I remembered the name.

Rednex

We had out first responder training last month at work. We work in a door building /machining plant , I brought up chest seals during class. We have had people shot in the chest /abdomen with  pneumatic finish nail guns , as in the nail went through the skin and is stuck someplace inside the body and a small hole is there. Trainer said a chest seal being used can't hurt anything,  it works or worst case it wasn't needed and now they lost some chest hair. Same for tourniquets unless its excessively long time it won't hurt anything. Now remember when he was talking he means like the 5-10 minutes it take for an ambulance to get there so the professionals can take over.

Z.O.R.G.

As I said before, It's been a while since I was actually certified (I worked on a commercial ambulance while attending college).  For trauma there was the "Golden" rule of 1 hour. If a trauma patient (MVA, GSW, stabbing, etc.) was on an operating table within 1 hour of the event occurring, they had a good likelihood of living.  Always make sure someone calls it in, never assume that someone did.

SSGMegaWatz

I am an AEMT/FF/Sar-tech... We carry HyFin chest seals in our trauma and MCI kits.  They are easy to use, and I can't think of a scenario where you would make the problem worse if you did it wrong.

As someone noted above, needle decompression should not be done by people without ALS training.  I doubt that Good Samaritan laws would protect anyone without the proper training using one.
Search & Rescue tech / Rope Rescue Tech / AEMT / FF

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