New York State Emergency Medical Technician (EMT) Practice Exam

In the case of an open chest wound with bubbling blood, what is the best immediate action?

1. Apply direct pressure with a sterile dressing

2. Control the bleeding and prepare for transport

3. Apply an occlusive dressing and continue assessment

4. Assist ventilations with a bag-mask device

The correct answer is: Apply an occlusive dressing and continue assessment

When dealing with an open chest wound that is bubbling blood, the immediate priority is to prevent air from entering the chest cavity. The presence of bubbling indicates that air is escaping from the lung through the wound, which can lead to a collapsed lung (pneumothorax) or a situation known as a sucking chest wound. Applying an occlusive dressing is crucial because it creates a seal over the wound to prevent additional air from entering the thoracic cavity. This dressing should ideally be a non-porous material that can adhere securely to the skin surrounding the wound. Once this seal is established, it can help stabilize the patient’s condition by allowing the lung to re-expand and reducing the risk of further respiratory distress. Continuing assessment is essential after applying the dressing, as monitoring the patient's vital signs and breathing is vital for determining the effectiveness of the intervention and identifying any further complications that may arise. This immediate action prioritizes both patient safety and stabilization until advanced medical care can be administered, making it a critical step in managing open chest trauma effectively.