Data from battlefield fatalities between 2001 and 2011 shows that 22.1% of deaths from battlefield were caused by gunshot wounds, many of these involving the chest area and these injuries lead to pneumothorax. Gunshot wounds to the chest lead to death in combat.
In civilian mass casualty events, chest wounds, especially those resulting in tension pneumothorax, are also a main cause of deaths.
In both combat and civilian emergencies, quick application medical supplies like occlusive dressings and decompression needles is critical in managing chest wounds to survive.
What is Occlusive Dressing and When to Use It?
Occlusive dressing is also called chest seal or shot patch. It's a kind of medical dressing for open chest wound injuries. The main purpose is to prevent air from entering the wound. Occlusive dressings are suitable for both civilian and military trauma care, it's essential medical care for battlefield or defense.
When to use an occlusive dressing ?
When there is open chest wound, the occlusive dressing should be used. When it happens, the air goes into the chest cavity. This trapped air builds pressure and causes the lung to collapse. As the pressure increases, it will compress the heart or blood vessels in the chest. This condition can rapidly become life threatening, immediate treatment should be involved to avoid more serious situation.
To prevent Tension Pneumothorax, you need to cover the open chest wound immediately to stop the air entering to the chest. Use the occlusive dressing to stop the air while there is vent channel to release the air from the chest.
What can we do without occlusive dressing ? You might find anything to cover the wound, such as CPR face shield, plastic case, etc. Apply the piece to cover the wound and seal the edge.
Steps to use the Occlusive Dressing
Here is a step by step guide.
Check for any chest injuries, especially if there is a sucking sound from the wound.
Cover the wound with the back of your hand while opening the package of occlusive dressing to minimize additional air entry. This helps to prevent more air from entering the chest.
Wipe the dirt or blood with gauze or wipe in the package. Apply the occlusive dressing on the wound, ensure it adheres to the skin around the wound. This stops air from entering the wound.
Tape or press the dressing tightly to secure, make sure the patch stays on chest without any problem.
Monitor for Tension Pneumothorax, watch the casualty check the breath, check if these symptoms happen:
Severe difficulty breathing
Distended neck veins
Decreased breath sounds on the injured side
Cyanosis (bluish skin)
If Tension Pneumothorax happens, use decompression needle to relieve the air if necessary.
Occlusive Dressing for K9
Just like humans, if K9 got gunshot or puncture wound, using chest seals immediately to stop air entering to the chest. What makes difference is to choose the best one for K9 as their skin is covered by hair, regular occlusive dressings do not work well for hairy surface.
K9 in combat situations face similar threats to human soldiers, occlusive could be a part of a tactical K9 first aid kit to help the dog survive in emergencies.
How technology is improving Occlusive Dressing
Early occlusive dressings were simple plastic sheets taped over wounds, but nowadays modern versions are more advanced.
Vented Chest Seals: These chest seals/occlusive dressings are designed with vented channel which can release the air while preventing new air from entering.
Advanced adhesion: Some modern dressings, like AeroLock Occlusive dressing, use stable reliable medical grade glue like Henkel that works even under extreme conditions. It works well in cold temperatures or when there is massive blood loss.
Lightweight and Compact: The medical supplies used for battlefield always require compact and lightweight. Modern occlusive dressings are also designed to be lightweight and compact to fit small first aid kits or IFAKs.
Challenges with occlusive dressings in the market
Adhesion performance in low temperature:
Many chest seals, especially those sourced from China, the adhesion fails to stick properly in cold conditions. In military, law enforcement or emergency response situations, this failure can mean the difference between life and death. Most of occlusive dressings in China are manufactured with similar materials and adhesive technologies, it's quite difficult to find something different.
Hair Interference:
Occlusive dressings are intended for human use but K9 also need it for first aid kits. You need to consider the adhesion performance on hairy surfaces, both for human and military working dogs.
How to choose a high quality Occlusive dressing ?
TCCC Recommended Brands:
Trusted chest seals like those from TCCC recommended brands, such as Hyfin or SAM are always the top choice. The Hyfin chest seal has become the industry standard for battlefield use, SAM chest seals are another trusted choice.
Testing is needed:
Test the performance beforehand is crucial, especially in winter or desert conditions. This is all about lives, no failure is allowed.
Here is a test report of most kinds of chest seals in different situations.
AeroLock as a new solution:
AeroLock is made with different materials that is designed to maintain adhesion even in freezing temperatures. This is different from the chest seals in the Chinese market. The affordable price makes it possible to save budget.
Conclusion
Occlusive dressings are essential medical supplies for trauma kit, whether it's for humans or military working dogs. Whether you are in the military, work in the emergency medical field, there are now many effective options to choose from various chest seals to help you save lives in emergencies.