The XL is for the wound a standard seal cannot cover with intact skin to spare. It rides beside your standard seals, not instead of them.
At a glance
10 things to know about the HALO XL
What the extra size buys you, where a non-vented seal fits in TCCC, and how to keep the casualty safe under it.
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01
Nearly twice the area of a standard HALO
The XL measures 11.63 × 8.30 in. (29.5 × 21 cm); the standard HALO Seal and HALO Vent measure 8.35 × 6.06 in.3,5 The adhesive has to reach intact skin all the way around a wound, and the XL buys that margin on a large or ragged one.
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02
Packed flat, not folded
The XL ships in a 10.875 × 7.5 in. flat pack. Products in the flat pack lie flat in the pouch, unlike the IFAK pouch, where seals are folded in thirds.3,5 It needs a flat slot in an aid bag or vehicle kit rather than an IFAK pocket.
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03
Non-vented, with a defined place in TCCC
The TCCC Guidelines dated 1 May 2026 call for a vented chest seal on every open or sucking chest wound, and a non-vented seal when a vented one is not available, followed by monitoring for a developing tension pneumothorax.1
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04
What the research says about non-vented HALO
The standard-size HALO, not the XL, was the unvented seal in a 2013 swine study: it restored breathing as fast as a vented seal, but with air still leaking into the chest it led to tension pneumothorax in all 8 animals after about 1.4 L.10 That research moved TCCC to vented-first in 2013.9 The XL uses the same non-vented design, so the same monitoring applies.
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05
Burp it when breathing worsens
The instructions list the warning signs: sharp chest pain, faster breathing, shortness of breath, a fast heart rate or low blood pressure, blue or discolored skin, lips or nails, and bulging neck veins — and direct re-sealing as required.4 Lift an edge with the pull tab to let trapped air out, or remove the seal; trained providers decompress.1
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06
Same adhesive system as every HALO
A hydrogel infused with scrim — a reinforcing mesh that limits gel migration — plus an outer tape edge as a second adhesion zone, with an oversized release liner for gloved or bloody hands. The manufacturer states it adheres in damp, dry, sandy and hairy conditions and with blood or pleural fluid present.3,4
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07
A large adhesive cover in the TCCC evisceration step
When eviscerated bowel cannot be replaced, the TCCC Guidelines direct covering it with water-impermeable, non-adhesive material and securing that cover with an adhesive dressing — a chest seal is one of the examples given.1 The seal sticks to skin around the cover, never to the bowel itself.
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08
Rated −30 °F to 140 °F, six-year shelf life
Medical Devices, Inc. rates the XL from −30 °F to 140 °F (−34 °C to 60 °C) with a six-year shelf life; its FDA device record lists the same storage range, non-sterile, single use and not made with natural rubber latex.3,7
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09
In the military supply system since 2010
The HALO XL carries NSN 6510-01-589-0995, an occlusive adhesive dressing cataloged as the HALO XL trauma wound seal and assigned in October 2010.3,8
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10
Not on the evidence-based device list — and no chest seal is
The Evidence-Based Standard Devices & Adjuncts list dated 15 December 2021 names no chest seal, so the HALO XL is not evidence-based standard; absence from the list does not by itself mean a product was tested and failed.2 It is an FDA-registered, Class I (510(k)-exempt) occlusive wound dressing from the company that launched HALO in 2009.5,6
How to apply the HALO XL
The sequence from the manufacturer's instructions and the TCCC Guidelines — with the monitoring a non-vented seal depends on.
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1Expose and find every hole. Cut clothing away and look and feel front, back, sides and armpits. Life-threatening bleeding is controlled first — tourniquet, packing, pressure dressing.
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2Cover it now. Put a gloved hand over the wound while you open the pouch.
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3Wipe it. Clean and dry the skin around the wound: blood, sweat and debris all fight the adhesive.4
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4Peel and place. Remove the clear liner without letting the gel touch anything else, then place the seal gel side down, centered over the wound.4
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5Press, don't stretch. Smooth it on with light pressure from the center out; a large seal wrinkles if it is stretched.4
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6Seal every other hole. Use another seal on any additional chest wound — a standard HALO on a smaller exit wound.4
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7Position and watch. Unconscious and breathing: recovery position. Conscious: let them sit up or take whatever position helps them breathe.1 Watch closely — a non-vented seal depends on it.
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8Worse? Burp it. Lift an edge with the pull tab to let trapped air escape, then press it back down — or remove the seal. Trained providers follow the Guidelines' decompression direction.1,4
Where it fits
- An open chest wound too large or irregular for a standard seal
- A large chest wound when no vented seal of that size is at hand1
- Securing a water-impermeable cover over eviscerated bowel that cannot be replaced1
- Aid bags and vehicle kits with room for a flat pouch
- Packing — never pack gauze into a chest or abdominal wound
- Over a protruding or impaled object — stabilize the object instead4
- Post-surgical wounds — a listed contraindication4
- Replacing standard seals in an IFAK — the XL is the extra, not the only
- Leaving unwatched — a non-vented seal needs someone monitoring breathing1
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 2013 | Animal · crossover | Unvented standard HALO vs vented Bolin seal on an open chest wound with an ongoing air leak, 8 swine | Both restored breathing within 5 min; the unvented HALO led to tension pneumothorax in all 8 after ~1.4 L of air, the vented seal held through 2 L |
| Schachner et al., Ann Thorac Surg 2022 | Bench · ex vivo | Improvised seals on a pig chest wall with a simulated open pneumothorax | Wet rescue-blanket squares sealed 5 of 5; plastic foil from a gauze wrapper sealed 0 of 5 |
| Butler et al., J Spec Oper Med 2013 | Expert review · TCCC change 13-02 | evidence-based review of open pneumothorax care after the 2013 swine data | Vented chest seal first; non-vented if no vented seal; monitor, burp or remove, decompress |
| Margolis et al., J Spec Oper Med 2014 | Expert consensus · C-TECC | Committee for Tactical Emergency Casualty Care review of vented vs non-vented seals | Vented seals likely add benefit; non-vented users reassess, burp and decompress; no clear outcome superiority proven |
| Paquette et al., J Spec Oper Med 2021 | Systematic review | Six quantitative chest seal studies, 1990–2020, including one human-participant adhesion study | No significant adherence difference among six seals including the standard HALO in the human study; device-level evidence limited |
| Lyng et al. (NAEMSP), Prehosp Emerg Care 2024 | Expert review · position statement | Structured review of EMS traumatic pneumothorax care | EMS may consider a vented seal in a spontaneously breathing patient; seals may be harmful during positive-pressure ventilation |
Strongest to weakest: human data, then animal studies, then bench work. The research above tested the standard-size HALO and non-vented seals as a type; the XL shares the same non-vented design and adhesive.
How it compares
The HALO line side by side — size, packaging and venting.
| HALO XL | HALO Seal (2-pack) | HALO Vent (2-pack) | HALO Combo | |
|---|---|---|---|---|
| Seal size | 11.63 × 8.30 in. (29.5 × 21 cm) | 8.35 × 6.06 in. (21.2 × 15.4 cm) | 8.35 × 6.06 in. | 8.35 × 6.06 in. |
| Pouch | Flat pack, 10.875 × 7.5 in. — seal lies flat | IFAK, 5.5 × 7.5 in. — folded in thirds | IFAK, 5.5 × 7.5 in. — folded in thirds | IFAK, 5.5 × 7.5 in. — folded in thirds |
| Vented | No — fully occlusive | No — fully occlusive | Yes — four vents | One of each |
| Seals per pack | 1 | 2 | 2 | 2 |
| Best fit | A wound too large for a standard seal | Entry and exit, when no vented seal is available1 | Entry and exit, vented-first1 | Vent on the first hole, Seal on a second |
| evidence-based standard | No | No | No | No |
The Evidence-Based Standard Devices & Adjuncts list (15 December 2021) names no chest seal of any brand;2 absence from the list does not by itself mean a product was tested and failed. Dimensions are the manufacturer's.3,5
Build the system
The standard HALO seals, the large abdominal dressing, a trainer, and the other jobs in the bag.
Questions buyers ask
Package & specifications
Specifications coming soon. Contact us for detailed product information.
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