What Is a Chest Seal and Why Is It in Your Kit
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By Kevin Wilson — Licensed Paramedic and Firefighter, 23 Years Prehospital Experience
Most people open their kit, pull out the HyFin Vent Chest Seal, and think, what exactly is this thing and when do I use it?
That is a fair question. And it is one worth answering before you are standing over someone who needs it.
Before we get into the details, North American Rescue, the manufacturer of the HyFin Vent, put together a training video that shows exactly how to apply it. Worth watching before you read the rest of this: https://www.youtube.com/watch?v=Fy_WHWG5F0k
What a chest seal actually does.
When someone takes a penetrating injury to the chest, a gunshot wound, a stab wound, a piece of metal at the wrong angle, something dangerous starts happening. Every time that person breathes in, air gets sucked into the chest cavity through the wound. That air does not belong there. It starts collapsing the lung. Left untreated it can compress the heart and major vessels. That is called tension pneumothorax and it can kill someone fast.
One critical point before we go further.
If the object is still in the chest, do not remove it. I want to be very clear about this. An impaled object in the chest wall is actually doing something important. It may be controlling the bleeding around the wound. Removing it in the field can cause catastrophic hemorrhage that was not happening before you pulled it out. That object needs to come out in an operating room with a trauma surgeon, not on scene and not in the back of an ambulance.
Stabilize the object with bulky dressings to prevent it from moving. Get that patient to definitive care fast. The chest seal applies to an open chest wound with a hole in the chest wall cavity, not an impalement. Those are two completely different situations and they require two completely different approaches.
A chest seal plugs the hole and controls the airflow.
If you want to see what happens when that air buildup gets released, I found a live needle decompression video that shows the moment of pressure release in a real patient. It is educational and it is graphic. Watch it here if you want to understand exactly what we are preventing: https://www.youtube.com/watch?v=co9_RLN78IY
Content warning: this is a live medical procedure.
The HyFin Vent Chest Seal does this with a three-channel one-way valve system. Think of it like a one-way door. During exhalation, pressure inside the chest pushes air out through those three channels. During inhalation, that same pressure differential causes the material to collapse over the vents and seal the wound so outside air cannot get back in. It continuously equalizes pressure in the chest and prevents tension pneumothorax from developing.
The three-channel design also has a built-in fail-safe, so even if two of the three channels get blocked by blood or debris the seal keeps working. That matters in a field environment where nothing is clean and nothing goes exactly as planned.
CoTCCC guidelines recommend vented chest seals as the first-line treatment for penetrating chest trauma. A published study confirmed that the HyFin Vent effectively evacuated air and blood and prevented tension pneumothorax in every test subject. This is not experimental. It is proven.
How to apply it.
The first thing you notice when you open the package is how sticky this thing is. That adhesive is engineered to maintain a seal even in the presence of blood, sweat, and everything else that comes with a traumatic injury. That tackiness is doing its job.
Here is how we apply it.
Use the enclosed sterile 4x4 gauze pad to wipe the wound area as dry as you can. You do not need it perfect, you just need it better. Remove the backing, center the seal over the wound, and press down firmly from the center outward. The product does the rest. The vent channels are already built in and you do not need to configure anything. Peel, place, press.
Gunshot wounds, use two seals.
A gunshot wound to the chest typically has an entrance wound and an exit wound. You need to seal both. Apply one seal to the entrance and one to the exit. If the wound is in a location where a standard chest seal cannot get a clean seal, like high up near the armpit or close to the spine, do the best you can with what you have and get that person moving toward definitive care.
Stab wounds can be more complicated. Multiple stab wounds mean multiple openings and multiple seals. Apply one to each wound and work fast.
What if you run out of chest seals?
This is the field reality nobody talks about. If you are dealing with multiple wounds and you run out of HyFin Vent seals, expired defibrillation pads, the large adhesive electrode pads from a cardiac monitor, can work as a temporary occlusive dressing. The large gel adhesive creates a seal over the wound. This is a last resort, not a substitute. The most important thing is that when EMS arrives or that patient gets to the ER, you tell the receiving team exactly what you used and where it is placed before they start working. That handoff matters.
This seal is in two kits.
The HyFin Vent Chest Seal is included in both Module 1 - Hemorrhage Control and Module 1-K9 - K9 Hemorrhage Control. Penetrating chest trauma happens to working dogs too, hunting dogs, trail dogs, working K9s, and a stick or branch at the wrong angle creates the same physiological problem. The seal works the same way.
Open your kit right now if you have not already. Find the HyFin Vent, read the packaging, look at the three vents, and understand what it does before you need it. Familiarity with your kit before an emergency is the difference between helping and freezing.
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Sources and References
HyFin Vent Chest Seal mechanism and clinical evidence:
Committee for Tactical Combat Casualty Care (CoTCCC) — Recommended Devices and Guidelines
North American Rescue HyFin Vent Chest Seal clinical documentation
Published research: vented chest seals including HyFin Vent confirmed to evacuate air and blood and prevent hemodynamic compromise in all test subjects
Impalement wound management:
Lee C, Porter K, Hodgetts T. Prehospital management of chest injuries: a consensus statement. Faculty of Pre-hospital Care, Royal College of Surgeons of Edinburgh. Emergency Medicine Journal. 2007. PMC2660039.
Knoop KJ, Stack LB, Thurman RJ. Impaled Foreign Body. The Atlas of Emergency Medicine, 5th Edition. McGraw Hill Medical.
EMS Chest Injury. StatPearls. National Center for Biotechnology Information, National Library of Medicine. NBK539743.
Use Caution with Impalement Injuries. Journal of Emergency Medical Services (JEMS). October 2024.
High Yield Thoracic Injuries. MedicTests.
EM@3AM: Impaled Objects. emDocs Emergency Medicine Education.
Key Takeaways:
- The HyFin Vent Chest Seal uses a three-channel one-way valve system to let air escape during exhalation while sealing the wound during inhalation. This prevents tension pneumothorax. CoTCCC recommends vented chest seals as first-line treatment for penetrating chest trauma.
- Wipe the wound area with the enclosed 4x4 gauze, center the seal over the wound, press firmly from the center outward. The product does the rest. Gunshot wounds need two seals, one for the entrance wound and one for the exit. Stab wounds may need multiple seals.
- If you run out of chest seals, expired cardiac monitor defibrillation pads can serve as a temporary occlusive dressing as a last resort. Always tell the receiving EMS or ER team exactly what you used and where it is placed.
Kevin Wilson, Founder | IFAK360
The information provided in this blog is for educational purposes only and does not constitute medical advice. Always seek professional medical care for injuries and emergencies. In an emergency, call 911.
Product images shown are for illustrative purposes only and may differ from actual items included in your kit.