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Old 06-13-2008, 12:04   #35
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Join Date: Jan 2004
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Originally Posted by swatsurgeon View Post
...1)Has anyone dealt with a true open chest wound where there was free movement of air both in and out of the pleural space...and used a 3 sided dressing or asherman type device.
Yes. Too many infact, both in the ER and at EMS.

2) What was the result? Did the dressing or device prevent the need to provide positive pressure ventilation (BVM or ETT intubation, etc) and most importantly, was it a true open chest wound?
I have used ACS, defib pads, large tegaderms, and seran wrap.

Of the patients who were conscious, and maintaining their own airways, all claimed relief of the SOB, until pressure built up from the 4-sided dressings requiring a needle-drill.

Of the ones who were ETT'd, O2 sats was higher until pressure increased, resulting in venting becoming more difficult, indicating the need for a needle-drill.

Hope that answered your questions...

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