Two holes, two seals, one pouch — and the dome on the valved seal is there because casualties wear armor, get strapped down and get moved.
At a glance
12 things to know about the SAM Chest Seal Combo
What the dome does, how the two seals split the work, and what the studies found for and against.
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01
Two different seals in one pouch
The Combo holds one valved dressing and one non-valved dressing.3,4 SAM sells the same seals as the Valved 2.0 (CS202-EN, one valved seal) and the Non-Valved (CS201-EN, two non-valved seals and a pad).3 The Combo is stocked as NSN 6510-01-656-8718, issued as one pack.7
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02
The TRUFLOW™ dome
The valved seal's rigid, raised-dome valve is built to keep one-way airflow out of the chest no matter the pressure applied, and large side vents minimize blockage from blood clots or soft tissue. SAM Medical states it keeps venting in transport and under heavy body armor.3 The dome shape is meant to stop blankets, clothing and armor from closing the air channels.7
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03
If the valve clogs, the seal becomes occlusive
SAM's instructions are direct: if the valve is clogged or obstructed, the dressing may become fully occlusive. The operator may try flushing the valve with sterile saline, keeps monitoring for tension pneumothorax, and treats it by lifting one side of the dressing to vent the wound or by needle decompression.4
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04
Hydrogel that reseals
SAM's hydrogel is built to adhere through sweat, blood, hair and sand, and even when submersed in water — and to reseal the wound after it has been lifted for venting.3
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05
A big oval seal with a thin edge
Each dressing measures 7 × 7 in. (17.8 cm). The oval shape maximizes the sealing surface; the dressing is transparent, elastic and conformable, and a thin edge layer resists lifting and peeling.3
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06
Two tabs
One or both tabs can be used to place, lift and remove the dressing — and to vent and reseal it.3,4
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07
Built to be found in the dark
The packaging, pouch, dressing backing and tabs are designed for contrast in normal light, low light and under night vision. The pouch opens by peeling from its tabs or tearing at the chevrons, and its inside provides a sterile field.3,4
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08
FDA-cleared — K102403
SAM Medical holds a 510(k) clearance for its chest seals: K102403, the SAM Chest Seal with Valve and SAM Chest Seal, cleared 3 March 2011.6 The Combo is listed under that clearance.5
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09
Six-year shelf life
SAM Medical gives the seal a 6-year shelf life. It is sterilized by irradiation and not made with natural rubber latex.3,4
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10
The evidence for it
In 24 swine with a communicating pneumothorax, the SAM, HyFin and Sentinel vented seals (8 each) all evacuated air and blood, and hemodynamic compromise did not develop with a seal in place.8 On soiled swine skin, the SAM was one of four seals that kept its adherence after storage at −19.5 °C and 71.5 °C.9
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11
The evidence against it
In a U.S. Army model of a bleeding chest wound in 26 swine, the SAM valved seal succeeded in 1 of 4 animals, against 6 of 6 for the Russell and the Sentinel; one-way-valve seals did not evacuate pooled blood efficiently and either lifted off or clotted.10 Each study tested the version available at the time — and the instruction for a clogged valve exists for exactly this reason.4
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12
Not evidence-based standard — and neither is any chest seal
The Evidence-Based Standard Devices & Adjuncts list 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.
How to apply the SAM Chest Seal
SAM Medical's four steps, 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 peel the pouch open at the chevron.
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3Clean the area. Wipe away blood, sweat and debris from around the wound.4
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4Grip the tab, remove the liner. Hold a tab and peel off the clear liner.4
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5Center and press. Place the dressing adhesive side down, centered over the wound, and press it firmly to ensure adhesion.4 The valved seal goes on first.
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6Seal the second hole. Use the non-valved seal on the second wound — or a second vented seal if you carry one. Keep the dome uncovered by clothing, straps and dressings.
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7Position and watch. Unconscious and breathing: recovery position. Conscious: a position of comfort, often sitting up. Watch the breathing and the valve.
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8If breathing gets worse, vent it. Lift one side of the dressing to vent the wound, or remove it; a clogged valve may be flushed with sterile saline. Trained providers decompress the chest as the TCCC Guidelines direct.1,4
Where it fits
- Open or sucking chest wounds from gunshot, stab or fragment injuries4
- Through-and-through injuries — one seal for the entry wound, one for the exit7
- Casualties in body armor, on litters or under straps — the dome is built to keep venting under pressure3
- 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
- Long-term wear — SAM intends the seal to stay in place only while the patient is transported to the hospital4
- Routine use on a patient receiving positive-pressure ventilation — the NAEMSP position is that chest seals may be harmful there14
- Reuse — single use only4
- Practice — train on a chest seal trainer
The evidence
Every study cited above, what it tested, and how strong it is — including the result that went against the SAM.
| Study | Evidence type | What was studied | What it found |
|---|---|---|---|
| Kotora et al., J Emerg Med 2013 | Animal · swine | HyFin, SAM and Sentinel vented seals (8 swine each) on a communicating pneumothorax, repeated air and blood challenges | All three evacuated air and blood; hemodynamic compromise did not develop with a seal in place |
| Arnaud et al., Injury 2016 | Animal · live swine skin | Adherence of vented seals on soiled swine skin, then after ~17 h storage at −19.5 °C and 71.5 °C | SAM, Russell, FastBreathe and HyFin kept their adherence after extreme storage; the Bolin scored lower |
| 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: SAM 1/4, Bolin 0/4, HyFin 4/6, Russell 6/6, Sentinel 6/6; valved seals detached or clogged |
| 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 | The unvented seal led to tension pneumothorax; the vented seal prevented it |
| 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 SAM vented well against air and held its adhesion; it lost ground when the chest kept bleeding under the valve.
How it compares
Other ways to put two seals — or one good one — in the kit.
| SAM® Chest Seal Combo | FoxSeal™ Twin Pack | Russell Chest Seal® | Sentinel™ Chest Seal | |
|---|---|---|---|---|
| In the package | 2 seals — 1 valved, 1 non-valved | 2 non-vented seals | 1 vented seal | 1 vented seal + gauze wipe |
| How it vents | TRUFLOW™ raised-dome one-way valve (valved seal only) | No valve — lift the peel tab to vent, then re-seal | Four peripheral apertures in a laminar hydrogel dressing | Dual vents: blood out the lower vent, air out the upper |
| Adhesive | Hydrogel that reseals after venting | Re-sealing adhesive for wet or hairy skin | Hydrogel on non-woven fabric | 360° acrylate (Sentinel 10x™) |
| Seal size | 7 × 7 in. (17.8 cm), oval | 5.1 × 5.2 in. (13 × 13.2 cm) | 8 × 6 in. (20.3 × 15.2 cm) | 6.5 × 6.5 in. (DLA record) |
| Bleeding chest wound, swine (2017) | 1 of 4 successful (valved seal)10 | Not in the study | 6 of 6 successful10 | 6 of 6 successful10 |
| FDA status | FDA-cleared, K102403 | Class I, 510(k)-exempt | Class I, 510(k)-exempt | Class I, 510(k)-exempt |
| 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 |
Designs and sizes from each manufacturer; the Sentinel's size from its DLA record. Swine results from Kheirabadi 2017.10
Build the system
SAM's own tourniquet, the other seals, decompression for trained providers, the trainer, and the rest of the IFAK.
Questions buyers ask
Package & specifications
Specifications coming soon. Contact us for detailed product information.
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Fulfillment Timeline: In stock merchandise ships within 48-72 hours from Florida HQ.
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30-Day Returns & Medical Safety
Returns: Unused, unopened equipment in original manufacturer packaging is eligible for return within 30 days of delivery.
Bio-Safety Notice: To ensure sterility and patient safety, medical consumables with opened or broken tamper-evident seals cannot be returned.
Return Facility: MED-TAC International Corp., 15757 Pines Blvd, Suite 154, Pembroke Pines, FL 33027.
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