For an open bubbling chest wound

• A. Occlusive dressing over the wound taped on three sides
• B. Wet compress and pressure dressing
• C. Dry gauze padding only
• D. Remove all dressings to visualize wound

Answer: (A)

The main concept is how to manage a penetrating chest wound to prevent a tension pneumothorax while sealing the wound. An occlusive dressing taped on three sides creates a flutter valve effect: it seals the chest to stop air from entering the pleural space, but the edge left untaped allows air to escape during exhalation. This minimizes air buildup in the chest without trapping air during inspiration. Wet compress with a pressure dressing wouldn’t provide a proper seal; dry gauze padding alone wouldn’t seal the wound; removing all dressings would expose and worsen the injury. Leave the three-sided occlusive dressing in place and monitor for signs of respiratory deterioration while arranging definitive care.