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Unstable pelvic fracture — DIPIMC MCQ

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HardPre-Hospital TraumaUnstable pelvic fractureDIPIMCDipIMC

A conscious casualty has a penetrating open chest wound that audibly sucks air. No occlusive dressing is yet in place and urgent transfer is being arranged. What first-aid action is appropriate?

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

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Correct answer: D — Leave it exposed or use a vented non-occlusive dressing and monitor

The best answer is “Leave it exposed or use a vented non-occlusive dressing and monitor”. Current first-aid guidance cautions against an unvented fully occlusive dressing because trapped air can convert an open pneumothorax into tension pneumothorax. Leave the wound open to the atmosphere or use a vented non-occlusive dressing according to protocol, monitor breathing continuously and be ready to remove any dressing if deterioration suggests tension. Deep packing and probing are unsafe.

Reference: Resuscitation Council UK, 2025 First aid guidelines: https://www.resus.org.uk/professional-library/2025-resuscitation-guidelines/first-aid-guidelines