> For the complete documentation index, see [llms.txt](https://handbook.teddwa.xyz/llms.txt). Markdown versions of documentation pages are available by appending `.md` to page URLs; this page is available as [Markdown](https://handbook.teddwa.xyz/gunshot-wounds/gsw-on-the-chest.md).

# GSW On the Chest

Seal chest wounds, monitor breathing, and transport urgently.

### Immediate actions

1. Complete the primary assessment (ABCs).
2. Expose the chest and locate every wound.
3. Check for entry and exit wounds.

### Treat the wound

Apply a chest seal to the entry wound. Apply a second chest seal to any exit wound.

### Monitor for deterioration

Watch for pneumothorax or tension pneumothorax:

* Increasing breathing difficulty or worsening oxygen saturation.
* Unequal chest rise or diminished breath sounds on one side.
* Cyanosis, tracheal deviation, or jugular vein distention.

Administer oxygen as needed. Continually reassess airway, breathing, and circulation.

### Monitor cardiac concerns

Attach a 12-lead ECG if available. Use it for irregular rhythm, unexplained hypotension, or other concerning symptoms.

### Transport

Transport as soon as possible. Continue monitoring throughout transport.


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