Using an Occlusive Dressing for Gunshot Wounds: A Step-by-Step Guide

Battlefield data from 2001-2011 reveals that 22.1% of combat fatalities were caused by gunshot wounds, with many involving the chest area leading to pneumothorax. These chest injuries are a leading cause of preventable deaths in combat scenarios.

Similarly, in civilian mass casualty events, chest wounds resulting in tension pneumothorax represent a significant percentage of preventable deaths.

In both military and civilian emergency situations, rapid application of proper medical supplies such as occlusive dressings and decompression needles is essential for survival.

What is an Occlusive Dressing and When to Use It?

An occlusive dressing, also called a chest seal or shot patch, is a specialized medical dressing designed specifically for open chest wound injuries. Its primary purpose is to create an airtight seal that prevents air from entering the wound while allowing trapped air to escape. These dressings are critical components in both civilian and military trauma care kits.

When to Use an Occlusive Dressing

You should apply an occlusive dressing immediately when dealing with an open chest wound. When the chest wall is penetrated, air can enter the chest cavity with each breath. This trapped air builds pressure and can cause the lung to collapse (pneumothorax). As pressure increases, it may compress the heart and major blood vessels in the chest (tension pneumothorax), quickly becoming life-threatening.

To prevent tension pneumothorax, cover the open chest wound immediately with an occlusive dressing to stop air from entering while allowing already trapped air to escape through vented channels.

If no occlusive dressing is available, improvise using any non-porous material such as a CPR face shield, plastic wrapper, or plastic bag. Secure it on three sides, leaving one edge unsealed to act as a one-way valve.

Step-by-Step Guide to Using an Occlusive Dressing

1. Assess the injury: Check for chest injuries, especially if you hear a sucking sound from the wound (indicating air movement).

2. Minimize air entry: Cover the wound with the back of your hand while preparing the occlusive dressing to prevent additional air from entering the chest cavity.

3. Clean the area: Quickly wipe away excess blood or debris using gauze to ensure proper adhesion of the dressing.

4. Apply the dressing: Place the occlusive dressing directly over the wound, ensuring it extends at least 2 inches beyond the wound edges for proper sealing.

5. Secure in place: Press firmly around the edges to create an airtight seal, ensuring the dressing adheres completely to the skin surrounding the wound.

6. Monitor for tension pneumothorax: Watch for warning signs including:

   • Severe respiratory distress

   • Distended neck veins

   • Decreased or absent breath sounds on the injured side

   • Cyanosis (bluish discoloration of skin)

   • Rapid deterioration of vital signs

7. Be prepared for needle decompression: If signs of tension pneumothorax develop despite the chest seal, a trained provider may need to perform needle decompression to release the trapped air.

Occlusive Dressings for Military Working Dogs (K9)

Military working dogs face similar threats to human operators in combat zones. However, their fur-covered skin presents unique challenges for standard occlusive dressings.

When treating a K9 with a penetrating chest wound:

• Choose specialized K9 chest seals designed for hairy surfaces

• If unavailable, apply firm pressure while clearing as much fur as possible from around the wound

• Use dressings with stronger adhesives specifically designed to work on fur-covered surfaces

Technological Advancements in Occlusive Dressings

Modern occlusive dressings have evolved significantly from the simple plastic sheets taped over wounds used in earlier decades:

Vented Technology

Today's advanced chest seals incorporate one-way valve systems or vented channels that allow trapped air to escape while preventing outside air from entering the wound. This helps prevent tension pneumothorax without requiring manual burping of the dressing.

Superior Adhesion

Products like the AeroLock Occlusive Dressing utilize medical-grade adhesives (such as Henkel) that maintain their integrity under extreme conditions including cold temperatures, excessive blood, and sweaty skin surfaces.

Compact Design

Modern occlusive dressings are engineered to be lightweight, compact, and easily deployable in tactical situations. Many fold to less than 1/4 of their deployed size, making them ideal for compact IFAKs and military medical kits.

Challenges with Occlusive Dressings in the Market

Temperature Performance

Many commercially available chest seals, particularly those manufactured in China, experience adhesion failure in cold environments. When temperatures drop below freezing, standard adhesives can become brittle and fail to create proper seals. In tactical situations, this failure can be fatal.

Hair/Fur Adhesion

Standard occlusive dressings struggle to adhere to hairy surfaces, making them less effective for certain body areas or for K9 treatment. This limitation requires specialized products or additional steps in emergency care protocols.

How to Choose a High-Quality Occlusive Dressing

TCCC Recommended Options

The Committee on Tactical Combat Casualty Care (TCCC) recommends specific chest seals that have proven effective in combat situations:

• Hyfin Chest Seal (industry standard for battlefield applications)

• SAM Chest Seal (trusted alternative with proven effectiveness)

• AeroLock Chest Seal (newer option with enhanced cold-weather performance)

Performance Testing

Before deploying any occlusive dressing in your medical kit, test its performance under various conditions:

• Cold weather adhesion

• Wet surface application

• Hairy surface adhesion

• Longevity of seal under movement

AeroLock: An Advanced Solution

The AeroLock occlusive dressing uses proprietary materials and adhesive technology specifically designed to maintain adhesion in extreme temperatures. Unlike many other Chinese-manufactured chest seals, AeroLock maintains its performance in freezing conditions while offering cost advantages compared to premium Western brands.

Conclusion

Occlusive dressings are essential life-saving components in any trauma kit, whether for human or K9 patients. With advances in medical technology, today's options provide better performance in challenging environments than earlier generations of chest seals.

Military personnel, law enforcement officers, emergency medical technicians, and prepared civilians should include quality occlusive dressings in their medical kits and understand their proper application. The right chest seal, correctly applied within the critical first minutes after injury, can mean the difference between life and death when dealing with penetrating chest wounds.

For bulk orders or customized tactical medical solutions, contact YEYETAC™ for professional consultation on the best options for your specific operational needs.

FAQs

Can I use plastic wrap as an improvised occlusive dressing?

Yes, clean plastic wrap taped on three sides can function as an emergency improvised chest seal when proper medical supplies aren't available.

How long can an occlusive dressing safely remain in place?

Most tactical occlusive dressings can remain in place for 24-48 hours, but should be replaced once definitive medical care is available.

Do all chest wounds require an occlusive dressing?

Only penetrating chest wounds that have created an open pathway to the pleural space require occlusive dressings.

Will applying an occlusive dressing hurt the patient?

While application may cause momentary discomfort, preventing tension pneumothorax far outweighs this temporary pain.

Should I remove an occlusive dressing if the patient's condition worsens?

If signs of tension pneumothorax develop after application, "burp" one edge of the dressing temporarily to release trapped air.

If signs of tension pneumothorax develop after application, "burp" one edge of the dressing temporarily to release trapped air.