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Open pneumothorax — DipIMC MCQ

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ModeratePre-Hospital Trauma ManagementOpen pneumothoraxDipIMC

A 24-year-old man has an open sucking wound to the right chest after a stabbing. He is anxious but has a palpable radial pulse and no tracheal deviation. What is the most appropriate management?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: C — Cover the wound with a simple occlusive dressing and observe for tension physiology

An open pneumothorax should be covered with an occlusive dressing while monitoring for evolving tension pneumothorax. Routine pre-emptive decompression is not indicated without severe respiratory compromise or haemodynamic instability. Circumferential tight bandaging may impair ventilation and does not reliably seal the wound. The pearl is that treatment must be reassessed because an occlusive dressing can convert an open pneumothorax into tension physiology.

Reference: NICE Major Trauma NG39; ATACC