Penetrating chest trauma requires careful assessment before acting. A small penetrating wound — from a knife blade, for example, can create a pathway for air to enter the pleural space and compress the lung, leading to obstructive shock. If the wound is making a sucking sound on inhalation, seal it with a vented chest seal or, if unavailable, an occlusive cover such as the plastic from inside a trauma bandage. If the hole is large enough to communicate air freely in and out, positioning is more important than sealing. Lay the person on the affected side to reduce accumulation in the pleural space. All penetrating chest injuries require urgent emergency medical care.
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