Open Pneumothorax

An open sucking pneumothorax occurs with a large open wound. Equilibration occurs between intrathoracic pressure and atmospheric pressure. This results in ineffective ventilation because air does not go into the lung, rather air is sucked into the pleural space from the outside environment. This may be managed by immediate closure of the defect with a large vaseline gauze, large enough to overlap the wounds edges. It is taped firmly in place on three sides, leaving the first side open to result in a one-way valve, such that any air that is trapped inside the pleural space would be extruded but air is not allowed to suck in from the outside environment into the pleural space. A chest tube should be placed and expeditious operative management performed to close the chest wound.

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