Emergency Medical Technician (EMT) Basic Certification Practice Exam

What is the recommended treatment for a chest impalement?

1. Apply an occlusive dressing on all sides

2. Apply an occlusive dressing on three sides

3. Cover with a standard bandage

4. Leave it exposed to reduce infection

The correct answer is: Apply an occlusive dressing on three sides

The recommended treatment for a chest impalement is to apply an occlusive dressing on three sides. This approach serves a critical purpose in managing an open chest wound. When an object penetrates the chest, there is a risk of air entering the pleural cavity, which can lead to a life-threatening condition known as a tension pneumothorax. By applying an occlusive dressing on three sides, you create a one-way valve effect; the dressing can allow air to escape from the pleural cavity during exhalation but prevents air from entering during inhalation. This is essential for maintaining lung function and preventing further complications. The open fourth side allows trapped air to exit, which is necessary to avoid the buildup of pressure in the chest. Other approaches, such as applying an occlusive dressing on all sides or using a standard bandage, would not provide this critical one-way valve effect, potentially worsening the patient's condition. Leaving the wound exposed could lead to contamination and infection, jeopardizing the patient's health even further. Therefore, the three-sided occlusive dressing is the most effective and appropriate method in this scenario.