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TCCC Guideline change 13-02 noted, there were no fatalities during OEF and OIF attributed to isolated open pneumothorax. 1 Described succinctly in a 1964 publication: If a wound in a chest wall communicates with the pleural cavity, there is usually an audible passage of air during both phases of respiration. 2 The principle here is although air enters the chest wall defect (eg, a gunshot wound) during inspiration, it also blows out on expiration

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