What is the first-line treatment for an open pneumothorax?

The first-line treatment for an open pneumothorax is to cover the wound with an occlusive dressing. This approach aims to create a barrier that prevents air from entering the pleural space through the open wound while allowing air that has already entered to escape. The occlusive dressing functions as a one-way valve during respiration; when the patient inhales, the dressing helps keep air from being drawn into the pleural cavity, which would exacerbate the pneumothorax.

Using an occlusive dressing is crucial in stabilizing the situation until further interventions, such as decompression or more advanced treatments, can be performed. It is essential to ensure that the dressing is secured well to minimize the risk of increased pleural air accumulation.

While administering supplemental oxygen can be beneficial, it is not a primary treatment for an open pneumothorax. Needle decompression is necessary in cases of tension pneumothorax but is not the first step for an open pneumothorax, where immediate sealing of the wound is prioritized. Applying a bulky dressing does not provide the necessary occlusive effect to prevent air movement effectively and is not the best initial step in this scenario.