What is the nurse's priority action when she hears a sucking chest wound?

What is the nurse's priority action when she hears a sucking chest wound?

• A. Apply a dry dressing and tape on four sides
• B. Elevate the chest and monitor vital signs
• C. Cover with petroleum gauze and tape on three sides
• D. Administer oxygen and reassess

Answer: (C)

Controlling air entry through a penetrating chest wound is the immediate priority. Sealing the wound with an occlusive petroleum gauze dressing and securing it on three sides creates a flutter valve: it stops air from being drawn into the pleural space during inspiration while still allowing air to escape during expiration. This setup reduces the risk of a tension pneumothorax, a dangerous complication that can rapidly impair breathing. Taping on all four sides would trap air inside the chest, potentially worsening a pneumothorax. While giving oxygen and watching the patient closely are important, they do not address the urgent need to prevent air from entering the chest. Elevating the chest or other measures don’t resolve the primary threat as effectively as an appropriate occlusive, flutter-valve dressing.

Controlling air entry through a penetrating chest wound is the immediate priority. Sealing the wound with an occlusive petroleum gauze dressing and securing it on three sides creates a flutter valve: it stops air from being drawn into the pleural space during inspiration while still allowing air to escape during expiration. This setup reduces the risk of a tension pneumothorax, a dangerous complication that can rapidly impair breathing.

Taping on all four sides would trap air inside the chest, potentially worsening a pneumothorax. While giving oxygen and watching the patient closely are important, they do not address the urgent need to prevent air from entering the chest. Elevating the chest or other measures don’t resolve the primary threat as effectively as an appropriate occlusive, flutter-valve dressing.