Watch: How to apply a chest seal
A chest seal is indicated for penetrating trauma victims to restore or maintain the ability for the patient to breathe through the normal route
NYPD Officer Ronald Kennedy was videoed using a Lays potato chip bag and tape, provided by a bystander, to save the life of a man who had been stabbed in the chest. The video showcases Kennedy’s quick thinking, command presence and resourcefulness to control the scene and deliver immediate casualty care before EMS arrived. According to the NYPD, hospital officials said Kennedy’s actions likely saved the victim’s life.
P1 reader trauma skills poll
Earlier this summer, Police1 asked readers, “Which trauma skill do you feel least confident performing?” Readers, not surprisingly, were most comfortable applying tourniquets as a lot of attention has been paid to learning and practicing this skill in recent years. Use of chest seals, again not surprisingly, was the skill 33% of respondents were least comfortable performing. Though stabilizing fractures was selected by 40% of respondents a broken extremity bone is rarely a life-threatening traumatic injury. Police officers, arriving before EMS, can make the most impact on patient survival by assessing and treating life-threatening bleeding, airway compromise and cardiac arrest.
Chest seal indications
A chest seal is indicated when a patient has penetrating chest trauma from neck to navel, on the front, side or back of the chest. The chest seal doesn’t control bleeding inside the chest cavity. Instead, the chest seal prevents air from entering the chest cavity. Air inside the chest cavity can make it difficult to impossible for the patient to breathe.
Chest seal application
The chest seal application steps, as demonstrated in the two videos below, are straightforward.
- Bare the patient’s chest.
- Wipe away blood and other fluids to identify the wound location.
- Apply the chest seal, following manufacturer directions, over the wound.
- Assess the opposite side of the patient’s chest, as well as the sides of the chest, for an exit wound.
- If there is an exit wound, apply another chest seal.
- Monitor the patient’s breathing.
After applying a chest seal, look for and treat other life threats, as you prepare for EMS to arrive.
Chest seal training videos
The below videos both cover how to apply a chest seal. To learn more about chest seal application, including hands-on training, contact your department’s medical director, tactical medic or EMS colleagues. As with any tactical or first aid skill, hands-on training, including scenario-based training with moulage patients, is critical to being able to competently and efficiently perform the skill in real life. It is very likely that NYPD Officer Kennedy had hands-on training and previous chest seal experience before he was filmed on July 7.
Joint Trauma System/Committee on Tactical Combat Casualty Care approved chest seal application video:
Williamson County EMS chest seal application video: