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Improvised chest seal

Posted Jan 05 2013 12:00am

Today I did some Macgyver playing in one of our airway kits. A new friend turned me on to an “old way” to make a nice, improvised chest seal complete with a flutter valve. Credit for this technique belongs to “Starlight” over at Close Protection World forums. While I am new to their community I have to say I have already seen a couple nice tricks and traded some info on their “Medics Forums”.

Here is a copy of his post teaching this method over on their forum. The pictures are added by me and taken earlier today playing with our airway kits and being bored on my off week.:

“OK Guys, leading on from my airway management thread, I thought I’d explain how to make an ACS out of a surgical glove.

Now, before any of you hard arsed medics out there in Oulooland, say “yeah, boreing, tell us something I don’t already know”, this is written for the benifit of all. I am very aware that there are aspiring medics out there who read these threads, because they are keen to be given professional info and improve their skills. So if you already know this (and I’m sure most of you will) don’t slag me off for trying to educate. Thanks guys.

So here we go:
An ACS is an Ascherman Chest Seal. They retail at about £10 a go, so are fairly expensive, and at an incident, you may need several of them. So I thought you may like to know how to make your own.

1. Take one (or several) of your surgical gloves and lay it flat infront of you with the thumb pointing away from you (towards the 12 O’clock)


2. Get your dressing sheers, and from slightly towards the palm from where the fingers join the palm, cut off all of the fingers. You should be left with a tube which is completely open at both ends, with a thumb attached. You should also be left with all of the fingers attached to a single very thin piece of glove. These also have a use, but for the purposes of this exercise, disguard the fingers bit.

3. With the glove still layed in front of you, with the thumb at 12 O’clock, cut the 6 O’clock part (closest to you) of the glove, length ways from the cuff to where the fingers were.

4. Now pick up what’s left of the glove and open it out. You should have a flat, roughly rectangular peice of glove with the thumb still attached, roughly central and pointing vertically. (can yer see what it is yet?)

5. Using whatever tape* comes to hand secure this firmly and on all sides over a sucking chest wound. Now snip off the top bit of the thumb. This will create a flutter valve, and help to prevent a Tension PX in the same way that an ACS would do.

*for tape, in an emergency use waterproof gaffer tape. I carry about a metre of this wrapped around and old credit card or similar. It then lays flat in your pocket, or tucked inside your body armour cover ready to use.

Obviously, the best thing to do is prep a few of these in a controlled environment BEFORE they’re needed in anger, and ALL team members should be carrying them, not just the medic.

I hope that all makes sense ladies and gents. When I demo this to others it takes me quite literally a minute, and makes instant sense. But expaining it in text, is a tad more difficult. So if it’s thrown up more questions that answers, or I’ve managed to thoroughly confuse someone, please feel free to comment on this thread.

I’ll answer publicly so that we all learn from the obs of others.

Keep safe,

Starlight Out

Now this is pretty damn cool! I think most of know the three sided occlusive dressing, burping it, etc. The concept of the flutter valve addition is a nice touch. I typically carry one or two of some commercially made “chest seals” in my vest/pack. What happens when you lose the pack or have three penetrating injuries? The ability to improvise is almost a requirement in an austere setting and this is a perfect example.

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