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Public safety partner education: How to apply a chest seal

Police officers, arriving before EMS, can make the most impact on patient survival by assessing and treating life threats

Chest seal.JPG

In a Police1 poll on trauma skills, use of chest seals was the skill 33% of respondents were least comfortable performing.

Williamson County EMS

NYPD Officer Ronald Kennedy was videoed using a Lays potato chip bag and tape, provided by a bystander, to save the life of a man who had been stabbed in the chest. The video showcases Kennedy’s quick thinking, command presence and resourcefulness to control the scene and deliver immediate casualty care before EMS arrived. According to the NYPD, hospital officials said Kennedy’s actions likely saved the victim’s life.

Police1 reader trauma skills poll

Earlier this summer, Police1 asked law enforcement officers, “Which trauma skill do you feel least confident performing?” Cops, not surprisingly, were most comfortable applying tourniquets as a lot of attention has been paid to learning and practicing this skill in recent years. Use of chest seals, again not surprisingly, was the skill 33% of respondents were least comfortable performing. Though stabilizing fractures was selected by 40% of respondents, a broken extremity bone is rarely a life-threatening traumatic injury. Police officers, arriving before EMS, can make the most impact on patient survival by assessing and treating life-threatening bleeding, airway compromise and cardiac arrest.

Educate your public safety partners in law enforcement to increase their confidence in saving a life before EMS arrives on scene. Share with your LEO colleagues chest seal indications, application steps and training videos.

Chest seal indications

A chest seal is indicated when a patient has penetrating chest trauma from neck to navel, on the front, side or back of the chest. The chest seal doesn’t control bleeding inside the chest cavity. Instead, the chest seal prevents air from entering the chest cavity. Air inside the chest cavity can make it difficult to impossible for the patient to breathe.

Chest seal application

The chest seal application steps, as demonstrated in the two videos below, are straightforward.

  1. Bare the patient’s chest
  2. Wipe away blood and other fluids to identify the wound location
  3. Apply the chest seal, following manufacturer directions, over the wound
  4. Assess the opposite side of the patient’s chest, as well as the sides of the chest, for an exit wound
  5. If there is an exit wound, apply another chest seal
  6. Monitor the patient’s breathing

After applying a chest seal, look for and treat other life threats, as you prepare for EMS to arrive.

Chest seal training videos

The below videos both cover how to apply a chest seal. Reach out to your local police departments to schedule a Stop the Bleed training course or a quick session on chest seal application. Tactical medics, who are already working with police, might have the pre-existing relationships and access to best deliver this training. As with any tactical or first aid skill, hands-on training, including scenario-based training with moulage patients, is critical to being able to competently and efficiently perform the skill in real life. It is very likely that NYPD Officer Kennedy had hands-on training and previous chest seal experience before he was filmed on July 7.

Joint Trauma System/Committee on Tactical Combat Casualty Care approved chest seal application video:

Williamson County EMS chest seal application video:

Additional first aid resources

Check out these additional resources to help educate your public safety partners:

Greg Friese, MS, NRP, is the Lexipol Editorial Director, leading the efforts of the editorial team on Police1, FireRescue1, Corrections1 and EMS1. Greg served as the EMS1 editor-in-chief for five years. He has a bachelor’s degree from the University of Wisconsin-Madison and a master’s degree from the University of Idaho. He is an educator, author, national registry paramedic since 2005, and a long-distance runner. Greg was a 2010 recipient of the EMS 10 Award for innovation. He is also a three-time Jesse H. Neal award winner, the most prestigious award in specialized journalism, and the 2018 and 2020 Eddie Award winner for best Column/Blog. Connect with Greg on LinkedIn.