When evaluating a casualty's chest wound, if unsure that the wound has penetrated the chest wall completely, what action should be taken?

• A. Treat as a closed chest wound
• B. Ignore and monitor
• C. Treat as if it's an open chest wound
• D. Call for medical evacuation

Answer: (C)

When you’re not sure if the chest wall is penetrated, treat it as an open chest wound. That mindset protects the casualty from a developing pneumothorax because a wound that could vent air needs an occlusive dressing that prevents air from being sucked into the chest while still allowing air to escape. Apply an airtight dressing over the wound and tape it on three sides to create a flutter valve, then monitor breathing and seek rapid medical evacuation. Don’t ignore it or assume it’s closed; the safest move is to treat it as open and manage the wound accordingly.