Problems of peculiar importance to thoracic injuries are open-chest wounds and tension pneumothorax. Open wounds of the chest must be converted to closed wounds in order to keep a functioning respiratory system. In the earliest phase of care, this may be accomplished by an adequate bandage. The picture of a patient with steadily increasing dyspnea, gasping respirations, and increasing cyanosis, in shock, with distended neck veins, flushed face, and a deviation of the trachea, with or without visible chest wound, may be diagnosed as indicating tension pneumothorax. The immediate requirement in such a situation is decompression, and this may be accomplished with any available needle. For transportation purposes, a needle may be left in place with a finger cot over the hub and a hole in one side to act as a flap valve. Injury to the lung parenchyma and bronchi poses two main problems, in addition to pneumothorax. These