|A penetrating chest wound may lead to several
significant problems. One immediate issue is the open pneumothorax that
leads to collapse of the lung.
In this condition, air can move freely in and out of the pleural space.
When breathing in, air is easily pulled into the pleural space, rather
than the lung. When breathing out, the air is expelled from the pleural
space, and the lung collapses.
A one-way chest seal quickly fixes this problem, by keeping air from
moving into the pleural space but allowing it to escape. After several
breaths, the lung will be re-expanded and functional.
The Asherman Chest Seal is pre-packaged in a sterile bag with a 4 X 4
- Use the 4 X 4 to clean and dry the area around the chest
- Peel off the protective paper liner, exposing the adhesive.
- Place the chest seal over the wound.
- With each breath, more air will be forced out through the flutter
valve, which also keeps outside air from returning to the pleural
If an Asherman Chest Seal is not available, a variety of
field-expedient chest seals can be quickly made.
Shown here is a plastic wrapper from a small battle dressing, covering
the wound and taped to the chest with adhesive tape. Note that a small
portion of the wrapper is not taped, to allow air to escape. Moisture
(blood, pleural fluid, etc.) underneath the plastic holds the plastic
against the chest wall and keeps air from coming back into the pleural
space during inhalation.
Any plastic-like material can work well for this purpose, including
Ziplock bags, cellophane wrappers, and latex gloves.