In jugular vein injury with risk of air embolism due to negative intrathoracic pressure, which action best prevents air entering?

• A. Apply a pressure bandage around the neck
• B. Elevate the head
• C. Massage around the wound
• D. Occlusive dressing over the wound

Answer: (D)

Air can be drawn into an open neck vein when intrathoracic pressure becomes negative during inspiration. Sealing the wound with an occlusive dressing creates a tight airtight barrier, preventing air from entering the vein and thus reducing the risk of an air embolism. Elevating the head, massaging the wound, or applying a pressure bandage around the neck do not reliably prevent air entry through an open jugular vein and can have other drawbacks (stopping bleeding vs. sealing air entry). So, a snug, airtight occlusive dressing is the best action.