Two different seals in one pouch only works if you know which is which before the pouch is open: the vented one goes on first.
At a glance
12 things to know about the HALO Combo
What is in the pouch, which seal goes where, and what the research says about each type.
-
01
One of each, by design
The pouch holds one HALO Vent and one HALO Seal.3 Medical Devices, Inc. sells the combination as a U.S. configuration alongside its all-vented and all-non-vented two-packs.6
-
02
Vented first, non-vented second
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.1 With this pouch, the first hole gets the HALO Vent; a second hole gets the HALO Seal. What is carried is what goes on: most seals placed on U.S. casualties with chest wounds in Afghanistan were non-vented, and the authors called for matching supply to the Guidelines.18
-
03
Tell them apart before you need to
Both seals are transparent and the same size. The HALO Vent is the one with a hydrogel-free window in the center and four vents around it; the HALO Seal has no window and no vents.3 Know which is which in daylight, not in the moment.
-
04
Why the vent matters
An injured lung can keep leaking air inside the chest after the hole is sealed. In a 2013 swine study, the unvented HALO led to tension pneumothorax in all 8 animals after about 1.4 L of added air, while a vented seal held through 2 L.12 That research moved TCCC to vented-first.11
-
05
How the HALO Vent vents
When pressure builds inside the chest, air lifts the cover layer and escapes through the vents; when pressure drops, the cover settles back and keeps the seal. The four vents let it drain whichever way the casualty is lying.3,10
-
06
The HALO Seal needs watching
A non-vented seal has no way to release trapped air on its own. The casualty is monitored, and the seal is burped or removed if breathing worsens; trained providers decompress.1,5
-
07
Two adhesives on both seals
Each seal uses a hydrogel infused with scrim — a reinforcing mesh that limits gel migration — and an outer tape edge as a second adhesion zone. The manufacturer states they adhere in damp, dry, sandy and hairy conditions and with blood or pleural fluid present.3,4,5 Clean and dry the skin first.
-
08
Big seals, small pouch
Both seals measure 8.35 × 6.06 in. (21.2 × 15.4 cm) and are folded in thirds into the 5.5 × 7.5 in. IFAK pouch.3,6
-
09
Rated −30 °F to 140 °F, six-year shelf life
Medical Devices, Inc. rates the seals from −30 °F to 140 °F (−34 °C to 60 °C) with a six-year shelf life; the FDA device record lists the same range, non-sterile, single use and not made with natural rubber latex.3,8
-
10
In the military supply system
The combo carries NSN 6510-01-694-9639, cataloged as an occlusive adhesive dressing containing one HALO Seal and one HALO Vent.3,9
-
11
Vent designs differ
With a bleeding chest wound in pigs, success ranged from 6 of 6 to 0 of 4 across five vented brands; one-way valves clogged with blood or the seal lifted off.13 The HALO Vent was not one of the five, and a 2021 systematic review judged the evidence on individual brands limited.14
-
12
FDA status
Both are FDA-registered, Class I (510(k)-exempt) occlusive wound dressings.7
How to apply the HALO Combo
The sequence from the manufacturer's instructions and the TCCC Guidelines, with the vented seal placed first.
-
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.
-
2Cover it now. Put a gloved hand over the hole — or have the casualty do it — while you open the pouch.
-
3Wipe it. Clean and dry the skin around the wound: blood, sweat and debris all fight the adhesive.4,5
-
4Vent on the first hole. Peel the HALO Vent's clear liner and place it gel side down with the vent centered over the wound. Light pressure; do not stretch.4
-
5Seal on the second. Apply the HALO Seal the same way, centered over the second wound.5
-
6Position and watch. Unconscious and breathing: recovery position. Conscious: let them sit up or take whatever position helps them breathe.1 Watch for worsening shortness of breath, faster breathing, a racing pulse or blue lips.4,5
-
7Worse? Burp it. Lift an edge with the pull tab to let trapped air escape and press it back down — or remove the seal. Trained providers follow the Guidelines' decompression direction.1,4,5
-
8Hand it off. Tell the receiving team which wound has the vented seal and which has the non-vented one.
Where it fits
- An open or sucking chest wound — the HALO Vent goes on first1
- A second chest wound — the HALO Seal, with close monitoring1
- IFAKs that carry one chest seal slot but want both types
- Wounds on wet, hairy or bloody skin once wiped3
- Packing — never pack gauze into a chest or abdominal wound
- Over a protruding or impaled object — stabilize the object instead4,5
- Post-surgical wounds — a listed contraindication4,5
- Two wounds that should both get vented seals — the HALO Vent two-pack does that
- 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 2013 | Animal · crossover | Unvented 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 |
| Kheirabadi et al., J Trauma Acute Care Surg 2017 | Animal · comparative | Five vented seals on a bleeding open chest wound, 26 swine | Success: Russell 6/6, Sentinel 6/6, HyFin Vent 4/6, SAM 1/4, Bolin 0/4; one-way valves clotted or detached |
| 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 |
| Schauer et al., J Spec Oper Med 2017 | Human · combat registry | 62 U.S. casualties with gunshot or puncture wounds to the chest, Afghanistan | 74.2% received a chest seal; most seals placed were not vented |
| 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 | HyFin Vent and Russell best supported; evidence on individual devices is 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 HALO Seal was the unvented arm of the 2013 swine study; the HALO Vent was not among the vented brands compared in 2017.
How it compares
The three HALO two-packs side by side, with the vented seal most often weighed against them.
| HALO Combo | HALO Vent (2-pack) | HALO Seal (2-pack) | HyFin Vent (twin pack) | |
|---|---|---|---|---|
| Maker | Medical Devices, Inc. | Medical Devices, Inc. | Medical Devices, Inc. | North American Rescue |
| What is in the pouch | 1 HALO Vent + 1 HALO Seal | 2 HALO Vent | 2 HALO Seal | 2 vented seals |
| Second wound gets | A non-vented seal — monitor and burp1 | A vented seal | A non-vented seal — monitor and burp1 | A vented seal |
| Published swine data | HALO Seal: tension pneumothorax in 8 of 8 with an ongoing air leak (unvented arm, 2013)12 | Not among the brands compared | Unvented arm, 201312 | Held in 4 of 6 with a bleeding chest wound13 |
All HALO seals measure 8.35 × 6.06 in.3,6
Build the system
The other HALO packs, a trainer, and the other three jobs in the kit.
Questions buyers ask
Package & specifications
Specifications coming soon. Contact us for detailed product information.
Domestic & Military Shipping
Free Standard Shipping: Automatically applied at checkout on all orders $200 and above within the 48 contiguous United States (CONUS).
APO/FPO Military Addresses: Unconditionally free standard shipping on every order, with no minimum purchase required.
Order Processing & Tracking
Fulfillment Timeline: In stock merchandise ships within 48-72 hours from Florida HQ.
Automated carrier tracking details are emailed immediately upon shipment dispatch.
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.
Export Compliance
North American Rescue (NAR) products and rifle hard armor plates are strictly restricted to US and APO/FPO addresses and cannot be exported internationally.
FREQUENTLY ASKED QUESTIONS
Customer Reviews
