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Open pneumothorax — DipIMC MCQ

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HardTraumaOpen pneumothoraxDipIMC

A spontaneously breathing patient has an open lateral chest wound with audible air movement. Blood pressure is 124/76 mmHg and severe respiratory compromise is absent. Which initial pre-hospital wound strategy follows NICE NG39?

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

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Correct answer: E — Apply a simple occlusive dressing and observe for tension

The best answer is “Apply a simple occlusive dressing and observe for tension”. NICE recommends covering an open pneumothorax with a simple occlusive dressing and watching closely for tension physiology. The evidence does not require a particular commercial vented device. Decompression is reserved for haemodynamic instability or severe respiratory compromise, while definitive drain placement and imaging belong to the receiving trauma pathway.

Reference: NICE NG39, Major trauma: assessment and initial management: https://www.nice.org.uk/guidance/ng39/chapter/recommendations