Management

1. Establish and maintain airway. Anticipate need for incubation if respiratory distress evident. 
2. Administer high humidified O₂, using non-rebreather mask. 
3. Establish IV access with two large gauge catheters. 
4. Remove clothing to assess injury sites. 
5. Monitor vital signs, level of consciousness, oxygen saturation, urinary output. 
6. Assess for tension pneurnothorax and, if present, do a needle thoracotomy. 
7. Dress sucking chest wound with non-porous dressing taped on three sides. 
8. Do not remove impaled objects; stabilize them with bulky dressings. 
9. Assess for other injuries such as bleeding and treat appropriately. 
10. Put patient in a semi-Fowler's position or lay patient on the injured side if breathing is easier.