After seeing an image on TV tonight I thought about something I heard many, many years ago while a knob (as in knobhead...no hair trainee) at Ft. Benning, GA.....
Sergeant: "Today Privates we will be going over treating a sucking chest wound.."
Private: "why do they call it a sucking chest wound?"
Sergeant: "because it sucks!...now shut the f' up and pay attention"
A sucking chest wound (now referred as often by its technical name "pneumothorax") is a condition where an injury allows air to enter the chest cavity and keeps the lungs from fully inflating and collapses them. The "sucking" in the name comes from the sound the wound may make as air is pushed in and out of it and is often accompanied by a frothy, bloody foam....sounds fun, right? Its generally not an all of a sudden collapse, depending on the size of the wound and amount of air getting into the cavity, but a gradual tightening on the lungs after each exhale....much like a snake squeezing its prey. Victims may be alert and responsive right after injury but will have trouble breathing, turn blue with cyanosis and eventually go into shock and...well, you get the rest. In the military when I got in it was generally assumed that this type of injury would be associated with a penetrating chest wound from a projectile..either bullet, fragment or blade. More recently since the advent of IED blast injury its been recognized that a blunt force trauma to the chest can cause the lungs to collapse and cause the same effect as a open wound into the chest cavity.
Pneumothorax puts the "SUCK into a sucking chest wound...
Traditionally the treatment consisted of using a "sterile" flat and flexible piece of plastic (we were told to try and use the wrappers of our field dressings...the inside "sterile" part towards the wound) underneath a traditional field dressing with one corner exposed to act as a "valve". The idea was that the one corner flap would allow air to escape when the soldier inhaled, but would collapse and seal around the wound when he exhaled and allow the pressure to lower to where the lung would inflate (assuming of course that it was still uninjured otherwise). Nowadays, they have dedicated chest dressings just for this type of injury such as the Asherman Chest Seasl (ACS), which are relatively inexpensive ($10 - $15) and do a much better job at sealing a traumatic wound than just a plastic wrapper. With the advent of the IED in Iraq and Afghanistan and soldiers being killed by pneumothorax caused by non-penetrating injuries from blast overpressure the services realized a need to modify training. Now soldiers are issued a 14 gauge needle in their IFAK (trauma kit) and taught how to do a needle decompression where the needle is inserted in the upper chest cavity to release this pressure.
ouch...avoid the ink...
In the 1999 movie Three Kings this procedure is more-or-less done correctly (by Hollywood standards) with some rather graphic, but informational, depiction...although I seriously doubt the patient would be as quick to recover and move around as Marky Mark Wahlberg does in this clip (I like his action movies but he is a hypocritical anti-gunner who open embraces their use in movies to make his $$$....see shooter...and btw as a felon movie prop masters have to be careful only to give him only weapons that cannot be converted to fire real ammo I am told as he cannot lawfully own his own guns.)...clip quality is crap but its the only one I can embed.
OK, so why would any "normal, non-military type need to know this stuff? Well, if you're reading this blog chances are you are a gun type and guns shoot bullets, which can cause type of condition...good to have a least a passing working knowledge of how to treat these injuries, wouldn't you say? Also, pneumothorax is not exclusive to the battlefield, penetrating injuries can occur from many types of accidents in and around the home and the condition itself can manifest as a secondary ailment in people with existing chest injuries. All in all not a bad little bit of info to share...but please seek some competent medical training on the subject and not just take my word on it, especially with regards to the needle decompression...not to be taken lightly by non-trained personnel.