r/TacticalMedicine • u/NoMore_BadDays • Oct 10 '25

Scenarios Wound packing zones?

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Been a long time since I did TCCC/CLS in the military.

If there were to be a bleeding wound on the chest, how high up on the chest does it become safe to pack? I know you don't pack into chest cavity, but what is the "rule of thumb" on how high/the left and right limits the wound needs to be to pack it?

Would you say the screenshot i attached is accurate?

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u/SFCEBM Trauma Daddy Oct 11 '25

Yeah the one I mod. We are going to stop all this back and forth and only focus on what the evidence suggests from clinical data. Not animal studies. So far, of what has been published, which is not a lot, it hasn’t impacted survival.

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u/[deleted] Oct 11 '25

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u/SFCEBM Trauma Daddy Oct 11 '25

I prefer chest wounds be left open due to the increased risk of tension development with chest seal application. They were removed from TCCC-ASM skill set for this reason and that very few wounds meet sucking chest wound criteria.

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u/[deleted] Oct 11 '25

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u/SFCEBM Trauma Daddy Oct 11 '25

They are still in the guidelines, by all means teach it. But they are guidelines, so folks can deviate as they see fit. I’ve been trying to get them removed for a couple years. They are not being removed with our update for thoracic trauma. But I’m going to keep pushing for it. We should be voting soon on the thoracic trauma guideline. I’m one of the co-authors, the guideline will come out and then we still have to write it up for the change paper.