The chest seal application will be reviewed during the video below, but a couple of points are worth mentioning in advance:

- Place hand or back of hand over open chest wound to create a temporary seal.
- When possible, use the chest seal from the casualty’s (JFAK).
- If the area surrounding the wound has blood, sweat, or dirt, simply wipe it away with 4X4 gauze from the commercial chest seal package. This will help the adhesive action of the seal to perform better.
- When casualty exhales, place adhesive side directly over open/sucking chest wound, pressing firmly to create a seal

Edges of the chest seal must extend 2 INCHES BEYOND the edges of the wound.

Continue to monitor the casualty after treatment with a vented chest seal. If the casualty condition worsens, a tension pneumothorax should be suspected. This will be discussed in detail later in this module but involves trapped air compressing the heart and great vessels and is significantly more dangerous than a standard open pneumothorax. If that happens, burping or removing, then replacing, the dressing may help – a procedure that will be explained in the video. Otherwise, a needle decompression of the chest may be needed.