A chest seal has two jobs — stay stuck and keep venting while the chest bleeds. The Russell did both in every animal in the Army's bleeding chest-wound test; your job is to wipe the skin, find every hole and keep watching the breathing.
At a glance
12 things to know about the Russell Chest Seal
How it vents, how big it is, what the studies found, and the mistakes that defeat it.
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01
A vent with no moving parts
The Russell is a hydrogel laminar dressing with an integral low-profile valve made of four apertures around the edge.3,5 Air and blood escape from the chest as the casualty breathes out, and air is not drawn back in on the next breath.4 Researchers group it with the laminar-channel seals rather than the one-way-valve designs.7,13
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02
Big — 8 × 6 inches
The seal opens to 8 × 6 in. (20.3 × 15.2 cm) and packs into a 5.5 × 5 in. pouch at 0.7 oz (19.8 g).3 It is folded inside the pouch: unfold it fully before it touches skin.4
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03
A window in the middle
A large central hole in the base material lets you see the wound as you place the seal, so the valve lands on the hole instead of beside it.3 Center the transparent part of the valve over the wound, then keep the valve clear and check it often.4
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04
Hydrogel on fabric
The adhesive is a water-containing hydrogel matrix mounted on non-woven fabric, which lets it follow curved anatomy and bony prominences.3,5 Silicone-coated release liners keep the dressing from stretching and distorting as the backing comes off.3
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05
Top result in a bleeding chest-wound model
U.S. Army researchers sealed bleeding chest wounds in 26 swine, then challenged each seal with more blood and air. The Russell and the Sentinel succeeded in 6 of 6 animals, the HyFin in 4 of 6, the SAM in 1 of 4 and the Bolin in 0 of 4. Valved seals clogged with clot or were lifted off by pooled blood; laminar seals let blood and air out.7
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06
It held on after hot and cold storage
In a Navy study on live swine skin soiled with contaminants, the Russell was one of four seals that kept its adherence after about 17 hours of storage at −19.5 °C (−3.1 °F) and 71.5 °C (160.7 °F); the Bolin did not.8 Safeguard Medical cites that study for the seal's temperature performance.3
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07
Reviewers rank it near the top — on thin evidence
A 2021 systematic review found six quantitative chest-seal studies and reached a consensus recommendation for the HyFin Vent and the Russell. The same authors note the evidence on individual devices is limited.9
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08
Wet or greasy skin defeats it
Excessively wet or greasy skin reduces how well the adhesive works; if the chest may be coated in a lipid-based lotion, cleanse it with a wet wipe first.4 Clear loose debris and fluid from around the wound before the seal goes on — blood, sweat and dirt are the real-world enemy of every chest seal.
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09
Rated for up to 24 hours
The Russell is a short-term device for use up to 24 hours, built to stay adhered over many hours of transport.4,5
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10
Four ways to ruin it
Do not place it over a protruding object, do not cover or smother the valve, do not cut the dressing, and do not reuse it — each one costs the valve its function or the casualty a sterile seal.4
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11
Not evidence-based standard — and neither is any chest seal
The Evidence-Based Standard Devices & Adjuncts list names tourniquets and hemostatic dressings; it has no chest-seal entries.2 The TCCC Guidelines call for a vented chest seal without naming a brand.1 Absence from the list does not by itself mean a product was tested and failed.
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12
Blue for Respiration
The blue pouch marks Respiration in Safeguard Medical's RAMPART™ color-coded system, so the seal is found by color under stress.3 It is sterile, not made with natural rubber latex, made in the USA and Berry compliant,3,4,5 and listed with the FDA as a Class I, 510(k)-exempt occlusive wound dressing.6
How to apply the Russell Chest Seal
The manufacturer's sequence inside the TCCC approach to an open chest wound.
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1Find every hole. Expose the chest and check the back, the sides and the armpits — the back is the wound people miss. Never pack gauze into a chest wound.
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2Cover it now. Put a gloved hand over the hole — or have the casualty use their own — while you open the pouch.
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3Wipe the skin. Clear blood, sweat, loose debris and fluid from around the wound; wet or greasy skin defeats the adhesive.4
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4Unfold and center. Unfold the dressing and center the transparent part of the valve over the wound.4
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5Peel, press — peel, press. Peel one liner and press the exposed adhesive onto the casualty; remove the second liner and firmly press the whole adhesive area down.4
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6Seal the second hole. An exit wound gets its own seal. Carry two.
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7Position and watch. Unconscious and breathing: recovery position. Conscious: a position of comfort, often sitting up. Keep the valve unobstructed, check it often and watch the breathing.4
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8If breathing gets worse, burp or remove it. Increasing distress, falling oxygen saturation or shock can mean a tension pneumothorax: lift the edge of the seal or remove it. Trained providers decompress the chest as the TCCC Guidelines direct.1
Where it fits
- Open or sucking chest wounds — front, back or side — from gunshot, stab or fragment injuries1
- The exit wound as well as the entry wound: one seal per hole
- Long transports and delayed evacuation — rated for up to 24 hours4
- Securing a water-impermeable cover over eviscerated abdominal organs that cannot be replaced; the TCCC Guidelines name a chest seal as one adhesive option1
- Packing — never pack anything into the chest or abdomen
- Placement over a protruding or impaled object4
- Cutting to size — a cut dressing loses its function4
- Routine use on a patient receiving positive-pressure ventilation — the NAEMSP position is that chest seals may be harmful there12
- Practice — train on a chest seal trainer
The evidence
Every study cited above, what it tested, and how strong it is.
| Study | Evidence type | What was studied | What it found |
|---|---|---|---|
| Kheirabadi et al., J Trauma Acute Care Surg 2017 | Animal · swine | Five vented seals on bleeding open chest wounds (hemopneumothorax), 26 swine, challenged with added blood and air | Success: Russell 6/6, Sentinel 6/6, HyFin 4/6, SAM 1/4, Bolin 0/4; valved seals clogged or detached with pooled blood |
| Arnaud et al., Injury 2016 | Animal · live swine skin | Adherence of vented seals on soiled swine skin; peel and pull testing, then after ~17 h storage at −19.5 °C and 71.5 °C | Russell, FastBreathe, HyFin and SAM kept their adherence after extreme storage; the Bolin scored lower |
| Kheirabadi et al., J Trauma Acute Care Surg 2013 | Animal · swine | Vented vs unvented seal on an open chest wound with ongoing air leak, 8 swine | Both seals improved breathing at first; the unvented seal led to tension pneumothorax, the vented seal prevented it |
| Paquette et al., J Spec Oper Med 2021 | Systematic review | Quantitative studies of chest-seal adherence and tension pneumothorax prevention, 1990–2020 (6 included) | Consensus recommendation for HyFin Vent and Russell; evidence on individual devices limited |
| Butler et al., J Spec Oper Med 2013 | Expert review · guideline change | TCCC Guidelines Change 13-02 on open pneumothorax | Vented chest seal first; non-vented if no vented seal is available; monitor and burp, remove or decompress |
| Lyng et al. (NAEMSP), Prehosp Emerg Care 2024 | Expert review · position statement | Structured literature review on EMS care of traumatic pneumothorax | EMS may consider a vented seal in spontaneously breathing patients; seals may be harmful with positive-pressure ventilation |
All of the device data are animal studies — there is no human trial of any chest seal brand. The 2017 model was the hardest test because the chest kept bleeding under the seal; the 2016 study measured adhesion only.
How it compares
The other vented seals buyers weigh against the Russell, on the facts that separate them.
| Russell Chest Seal® | Sentinel™ Chest Seal | Bolin™ Chest Seal | SAM® Chest Seal Combo | |
|---|---|---|---|---|
| How it vents | Four peripheral apertures in a laminar hydrogel dressing — no moving valve | Dual vents with an internal channel: blood out the lower vent, air out the upper | Three one-way valves in a row | TRUFLOW™ raised-dome one-way valve on the valved seal; second seal non-valved |
| Adhesive | Hydrogel on non-woven fabric | 360° acrylate (Sentinel 10x™) | Thick hydrogel, removable and reapplicable | Hydrogel that reseals after venting |
| Seal size | 8 × 6 in. (20.3 × 15.2 cm) | 6.5 × 6.5 in. (DLA record) | 6 in. (15.25 cm) diameter | 7 × 7 in. (17.8 cm) |
| Seals per package | 1 | 1, plus a gauze wipe | 1, plus a gauze pad | 2 — one valved, one non-valved |
| Bleeding chest wound, swine (2017) | 6 of 6 successful7 | 6 of 6 successful7 | 0 of 4 successful7 | 1 of 4 successful (valved seal)7 |
| FDA status | Class I, 510(k)-exempt | Class I, 510(k)-exempt | Class I, 510(k)-exempt | FDA-cleared, K102403 |
| evidence-based standard | No — the list names no chest seal | No — the list names no chest seal | No — the list names no chest seal | No — the list names no chest seal |
Sizes and designs from each manufacturer (Sentinel size from its DLA record); swine results from Kheirabadi 2017.7 The HyFin, tested in the same study, succeeded in 4 of 6 animals.7
Build the system
The other vented seal that scored 6 of 6, the kits that carry the Russell, the trainer, and the rest of the IFAK.
Questions buyers ask
Package & specifications
| Specification | Value |
|---|---|
| Width | 8 Inches |
| Length | 6 Inches |
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