Rescue Blanket as a Provisional Seal for Penetrating Chest Wounds in a New Ex Vivo Porcine Model

Abstract

BACKGROUND Open pneumothorax after a penetrating thorax trauma is a life-threatening disease with high mortality.An emergency application of a chest seal (CS) allowing the release of trapped air is the optimum initial therapy until surgical chest drainage is available.METHODS In a newly developed experimental porcine model of open pneumothorax, we tested 3 different materials regarding their applicability for acute treatment of sucking chest wounds in prehospital emergency care, namely a commonly used rescue blanket (RB), plastic foil from a gauze package (packing material), and a commercial CS. RESULTSAn ex vivo open pneumothorax model using a porcine chest wall and a vacuum-assisted drainage system was successfully established. RB segments sized 70 3 100 mm achieved significantly higher rates of successful sealing than plastic foils from a gauze package sized 100 3 100 mm when the devices were applied to the moistened chest wall and fixed on 3 sides (5/5 [100%] vs 0/5 [0%], respectively; P [ .002). Loosely fixed RBs efficiently released injected air (10/10 [100%]) and consequently sealed the wound in all cases (10/10).CONCLUSIONS RBs, applied wet, are appropriate CSs with good occlusive and adherence properties. Fixation on 2 sides of the dressing is sufficient to allow trapped air to exit while providing appropriate sealing of the chest wound. RBs were superior to plastic foils from a gauze package and were seen to function as a potent makeshift CS when no commercial CS is available.

Rescue Blankets as Multifunctional Rescue Equipment in Alpine and Wilderness Emergencies—A Narrative Review and Clinical Implications

“…Beside the quantitative synthesis of the conventional function of rescue blankets to protect from hypothermia, wind and moisture, we qualitatively evaluated alternative functions of rescue blankets and identified nine articles for review [6][7][8][10][11][12][13][14][15]. The various alternative functions of rescue blankets comprised block of ultraviolet and infrared radiation, transparency, tensile strength, smoothness and tightness that allowed application as makeshifts of bandages, pelvic binders, tourniquets, chest seals, infection barriers, sunglasses and transport facilities in remote areas.…”

“…Then again, air could evade the cover easily under positive intrathoracic pressure. Since commercially available chest seals are uncommon in first aid kits of those who participate in outdoor sport, one single piece of the rescue blanket might serve as a valuable substitute [12].…”

“…Application of a rescue blanket as makeshift chest seal Schachner et al recently developed an ex vivo porcine model of open pneumothorax, and observed favorable properties of the rescue blanket when used as a non-occlusive chest seal (Figure 8) [12]. Application of a loosely fixed wet-surfaced piece of rescue blanket proved to have good sealing effects in treating an experimental sucking chest wound.…”

Rescue blankets as multifunctional rescue equipment in alpine and wilderness emergencies: a commentary

“…Whenever non-occlusive dressings are not available, makeshift chest seal of polyvinyl chloride packing may be used by first aid providers [13]. In an experimental study we assessed the fitness of a rescue blanket as a provisional seal for penetrating chest wounds in a new ex vivo porcine model [14]. We could show, that the smooth and moist surface of the blanket provides adequate tightness when applied as makeshift chest seal in sucking chest wounds [14].…”

“…In an experimental study we assessed the fitness of a rescue blanket as a provisional seal for penetrating chest wounds in a new ex vivo porcine model [14]. We could show, that the smooth and moist surface of the blanket provides adequate tightness when applied as makeshift chest seal in sucking chest wounds [14]. Even more, the watertight and windproof foil can be used as a rain shield, a wind shield, a stopgap bivouac sack, and a water reservoir in the wilderness [15].…”