If an open chest wound shows signs of developing tension pneumothorax, what is the immediate corrective action you should take?

• A. Release pressure by lifting the unsecured portion of the occlusive dressing
• B. Apply more occlusive tape to seal the wound
• C. Seal the wound completely with a rigid dressing
• D. Proceed directly to needle decompression without modifying the dressing

Answer: (A)

Relieve the built-up pressure by lifting the edge of the occlusive dressing. An open chest wound is managed with a dressing that allows air to escape; if signs of tension pneumothorax appear, the immediate step is to vent the wound briefly by lifting the unsecured portion so air can escape during inspiration. This decompresses the chest and reduces intrathoracic pressure. After venting, re-secure the dressing to maintain a seal while still permitting ventilation. Sealing more tightly or applying a rigid dressing would trap air and worsen tension, and jumping straight to needle decompression without first venting may miss the rapid relief this venting provides.