Skip Ribbon Commands
Skip to main content
SharePoint

PublicComment

 Feedback

If you have any comments or questions on this page, please email us at:
 

First aid treatment for open chest wound

Question Type:
Intervention
Full Question:
Among adults and children who are being treated for an open chest wound outside of a hospital (P), does occlusive bandage application or occlusive device (I), compared with a non-occlusive dressing (C), change improve survival, respiratory arrest, oxygen saturation, vital signs, the rate of cardiac and respiratory arrests, improve therapeutic endpoints (oxygenation and ventilation) (O)?
Consensus on Science:
For the critical outcome of respiratory arrest, we identified very-low-quality evidence (downgraded for risk of bias, indirectness, and imprecision) from 1 animal study(Kheirabadi 2013, 150) showing benefit from using a nonocclusive device (RR, 0.059; 95% CI, 0.004–0.874). For the critical outcome of oxygen saturation, we identified very-low-quality evidence (downgraded for risk of bias, indirectness, and imprecision) from 1 animal study(Kheirabadi 2013, 150) showing benefit from using a nonocclusive device (P
Treatment Recommendation:
​We suggest against the application of an occlusive dressing or device by first aid providers to individuals with an open chest wound (weak recommendation, very-low-quality evidence). Values, Preferences, and Task Force Insights In making this recommendation, we place higher value on the avoidance of the potential life-threatening complication of tension pneumothorax, compared with other risks associated with an open chest wound. Public comments expressed concern about making a recommendation based solely on a single animal study. The task force took into consideration the potential life-threatening complication of an unrecognized tension pneumothorax associated with the use of an occlusive dressing or device in the first aid setting. In addition, the review recognized the long-standing accepted clinical practice of treating a tension pneumothorax by creating and maintaining an open communication between the pneumothorax and ambient air. Furthermore, while this will require a change for some in current teaching, there was recognition of the practicality and acceptance in the first aid setting of leaving an open chest wound exposed to ambient air without a dressing or seal. The task force discussed the reality that many dressings, both initially and over time, may themselves produce inadvertent partial or full occlusion and that this needs to be recognized as a serious potential complication.
CoSTR Attachments:
GRADE table - FA treatment for open chest wound.pdf    

 Contact Us

 
If you have any comments or questions on this page, please email us at: