An open pneumothorax occurs when a penetrating injury creates an opening in the chest wall, allowing air to enter the pleural space and impairing normal lung expansion.

Open chest injuries should be suspected in any patient with penetrating trauma to the chest, back, or upper torso. Assessment findings may include:

  • Visible chest wound
  • Shortness of breath
  • Respiratory distress
  • Chest pain
  • Decreased breath sounds
  • Air movement through the wound

The primary treatment goal is to prevent additional air from entering the pleural space while allowing trapped air to escape.

Management includes:

  • Identify and expose the wound.
  • Apply an appropriate vented chest seal.
  • Monitor respiratory status closely.
  • Reassess frequently for signs of deterioration.
  • Be prepared to manage a developing tension pneumothorax.

If it’s open — close it.

Sealing the chest wall defect helps restore normal respiratory mechanics and reduces further air entry. Reassess continuously – patient condition can change rapidly following chest injury.

Remember: Treat the wound, monitor the patient, and reassess frequently for respiratory deterioration.

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