When should a chest seal be placed on a penetrating chest wound?

• A. Immediately after injury
• B. During inhalation
• C. Upon exhalation
• D. Only if bleeding is heavy

Answer: (C)

Open chest wounds risk air rushing into the pleural space with each inhale, so you want a seal that blocks that air entry as soon as the next breath begins. Placing the chest seal at the end of exhalation achieves that: the dressing is already in place and ready to stop air from entering during the upcoming inspiration. If you try to seal during inhalation, air is already moving through the wound, and the seal is less likely to prevent a pneumothorax from worsening. Bleeding control matters, but the timing of the seal is about how the chest breathes, not about whether bleeding is present.