Sucking Chest Wound: Symptoms & Treatment

Instructor: Artem Cheprasov

Artem has a doctor of veterinary medicine degree.

This lesson describe the concept of a sucking chest wound. You'll learn its basic pathophysiology, potential signs and symptoms, as well as its most immediate treatment.

(Non)-Obvious Conditions

You know, some things in medicine are super-difficult to understand unless you know medical terminology. For example, hyperbilirubinemia is kind of difficult to pronounce, let alone understand, unless you have medical training. But other things are thankfully pretty clear cut in exactly what they are. Take this lesson's topic, sucking chest wound. You're going to learn pretty quickly that it tells you what it is right from the start. Let's learn about this condition's signs, symptoms, and treatment.

Pathophysiology, Signs & Symptoms

The term sucking chest wound gives away one of the signs of the condition by name alone. It's a wound in the chest that creates a 'sucking' or 'hissing' noise as a person breathes.

Why? Well, it's because something has penetrated the chest and created an open channel of communication between the thorax (chest) and the environment. This is not good.

See, the chest cavity must be sealed off from the outside environment in order for the lungs to properly inflate during inhalation. The anatomical and physiological discussion of this is beyond this lesson's scope but, suffice it to say, if the chest cavity is penetrated, then the lung collapses since it can't inflate against the column of outside air pressing down upon it.

This scenario, a collapsed lung, is broadly called a pneumothorax. More specifically, it's an open pneumothorax, because the collapsed lung is caused by an open channel of communication between the environment and chest cavity as a result of a defect in the chest wall.

During pneumothorax, a lung collapses.
During pneumothorax, a lung collapses.

Besides the sucking noise, other signs and symptoms of a sucking chest wound to look out for include:

  • Dyspnea, or difficulty breathing
  • Tachypnea, which is rapid and shallow breathing
  • Tachycardia, which is a fast heart rate
  • An absence of breathing sounds on affected side of the chest
  • Pain
  • Obvious evidence of trauma to the chest
  • The bubbling or 'spitting' of blood around the wound as a person breathes

Not every 'hole' (defect) in the chest will create a sucking chest wound, however. Usually, the hole needs to be at least 66% the width of the trachea, the person's windpipe. An easy way to gauge this is to imagine that if the hole is bigger than a penny, then that means a sucking chest wound and severe respiratory impairment could be the end result.

The mechanics of lung action during inhalation in a sucking chest wound.
The mechanics of lung action during inhalation in a sucking chest wound.

The mechanics of lung action during exhalation in a sucking chest wound.
The mechanics of lung action during exhalation in a sucking chest wound.


Since one of the initial problems is severe respiratory impairment, you better believe that a sucking life wound is an emergency condition, and thus requires immediate attention. This lesson is only able to cover the immediate steps you'd need to take to treat this problem.

Let's think about this logically. If you have a hole in the chest wall and the person has difficulty breathing as a result of it, what would you do about it? You don't need any medical training to figure this one out. What would you do to stop a leak on a leaky boat? You'd patch up the hole, right?

Well, that's what we'd do in medicine as well. We'd 'patch up' the hole. That would be the most immediate treatment for a sucking chest wound. There's more than one way to do this, depending on what you have available and what situation you are in.

For instance, a ready-made, single-step chest seal with a flutter valve/tube can be used. This would allow the person to breathe in normally but exhale partially through the one-way valve in their chest. The valve prevents air from being sucked back into the chest as the person breathes in.

What if you don't have this on hand to seal things up? In that case, a 3 sided occlusive dressing can be placed over the wound to create something similar to a one-step flutter valve, albeit not as effectively.

In other words, some sort of air-tight material is placed over the wound, extended at least 2 inches beyond the edge of the wound on all sides, and taped to the skin on three sides. Don't use a small dressing if you can avoid it, as it might get pulled into the wound instead as the person breathes in.

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Sucking Chest Wound: Symptoms & Treatment Quiz

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The most immediate treatment for a sucking chest wound is which of the following?

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