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What can be done to help at the site to aid in breathing when gun shot enters the thorax and exits out the back?
Astriid
First, make SURE the scene is safe and MAKE SURE someone has called 9-1-1. If it is safe, check to make sure the victim's airway is open and they are breathing. The next thing you need to do is place an "occlusive dressing" taped on three sides on both of the wounds. The reason for this is that as we try to take in a breath, the chest cavity expands. The air will come in through the opening with the least resistance. In the mouth or nose, past the tongue, through the trachea (the windpipe), and into the lungs is NOT the pathway with the least resistance when we have two large holes going directly into the chest and lungs. So, for breathing to work, we need to cover over the openings.
BUT, we can't just completely cover them up. Exhaling works the same way (path with the least resistance going out of the lungs), so when the victim exhales, the air will want to go out of the lungs through the bullet holes and into the chest cavity. If it can't get out of the chest cavity, pressure will build up and cause the lungs to collapse.
The proper way to apply the occlusive dressing is to clean the chest and back as much as you can so tape will stick, cover the wound with something that is about 4x4 to 6x6 inches square that air won't go through (plastic wrap, baggie, aluminum foil, etc). Then tape it down to the chest with any kind of tape that will stick (yes, Duct Tape will work just fine). BUT, only tape it down on three sides -- leave the fourth side untaped. Then do the same to the back.
When the victim takes a breath in, the dressing will seal down over the wound and keep air from coming in through it. When they exhale, the air that builds up inside the chest will escape through the untaped side of the dressing and keep the chest from pressurizing and causing the lungs to collapse. Trust me, it works. Once that is done, work to control any bleeding, elevate the feet and legs about 12 inches to help maintain blood pressure in the body, cover the victim to keep them warm and be prepared to perform CPR if they stop breathing.
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∙ 14y ago
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