Upon discovering an open chest wound, you should which of the following?

• A. Prevent air from entering the open wound
• B. Quickly cover the wound with a porous trauma dressing
• C. Begin assisted ventilation and prepare for transport
• D. Immediately reassess the patient's ventilatory status

Answer: (A)

Open chest wounds create a pathway for air to be drawn into the pleural space with each breath, which can collapse the lung and lead to a tension pneumothorax. The priority is to seal the wound with an airtight occlusive dressing so air cannot enter the chest cavity. This stabilization stops further air from entering and helps prevent a worsening pneumothorax, buying time for transport and definitive care. Using a porous dressing would not stop air entry, and starting ventilation before sealing could push air into the chest. Reassessing ventilatory status and continuing care are important, but securing the chest seal takes precedence to protect ventilation.