What is a sucking chest wound and how is it managed?

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A sucking chest wound is an open chest wound that communicates with the pleural space, so air is drawn into the chest with each breath, which can collapse the lung and, if pressure builds, cause a tension pneumothorax.

The best management is to apply an occlusive dressing taped on three sides. This creates a flutter-valve effect: it seals the wound to prevent air from being sucked into the chest during inspiration, but still allows air to escape if pressure increases, reducing the risk of a tension pneumothorax. Airway and breathing are the priority, so ensure the airway is clear and provide supportive breathing care (high-flow oxygen if available) while monitoring for deterioration and arranging urgent care. Fully sealing on all four sides or using dry gauze alone would either trap air or fail to seal properly, making three-sided occlusion the preferred approach.