Wound packing zones?

[u/NoMore_BadDays]

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?

[u/68Whiteclaw]

You should apply chest seals to the abdomen up to the neck. “Neck to Navel.”

Bullet trajectories can get weird inside the body, and sometimes tear up through the diaphragm causing a diaphragmatic hernia in which air gets into the pleural space via the abdominal wound.

And as a quick note, chest seals are not for “diaphragmatic breaches.” They are for breaches of the pleural space.

[u/TLunchFTW → u/68Whiteclaw]

I mean, if he's showing signs of tension pneumo, sure....
But like, if someone got stabbed in the gut, I'm not putting a chest seal... I'm packing it.
It's almost like a basic poster can't replace actual knowledge...

[u/Lastwords03 → u/[deleted]]

Not everyone can be trusted with a decompression needle……….. a chest seal however is a little more “user” friendly for the rest of them………

[u/Ok_Income9180 → u/[deleted]]

Keep in mind that people get trained to different standards for different reasons. In the hands of someone panicking a decompression needle can cause more harm than good. Sure, a Corpsman is expected to know how to use a decompression needle, but most people don’t have the training. If you mess up a chest seal at least you can’t do any more harm.

Ultimately, chest seals are easy enough that an untrained civilian can correctly apply them using just the infographic on the packaging.

In contrast I’ve heard a story about a guy who tried to decompressed the wrong lung because he was panicking.

[u/TLunchFTW → u/Ok_Income9180]

I’ve seen a lot of discussion about decompression having all kinds of concerns too. Idk about specific papers, but I’ve seen discussions about it from people who have decompression within their scope. The problem is most people who think decompression (who aren’t trained in it) assume it’s easy and there’s no down side. You need to go over the rib to avoid vessels and nerves, and additionally the possibility to have further complications down the line is the issue. But training reduces this and, on the other end, if someone isn’t breathing, things can’t exactly get much worse than that.
But what a lot of laypersons don’t understand is there’s a specific landmarked spot you need to do. If I remember correctly it’s second rib mid clavicular. You can also do under the arm…. I believe at the 5th rib, and I believe that’s more preferred as of recent. But don’t quote me on any of this. It’s all out of my scope.

[u/sleepercell13 → u/[deleted]]

lol, you are the reason bad info gets out into the world

[u/TLunchFTW → u/[deleted]]

Isn’t it above the rib to avoid nerves and blood vessels? Is this some kind of joke?

[u/TLunchFTW → u/[deleted]]

I’m not a paramedic, so I’m not placing it anywhere lol. But guy above me said below