Needle thoracostomy: Difference between revisions
| Line 1: | Line 1: | ||
==Indications== | ==Indications== | ||
*Suspected [[tension pneumothorax]] needing immediate decompression | *Suspected [[tension pneumothorax]] needing immediate decompression | ||
**Blunt chest trauma, shortness of breath, asymmetric lung sounds, deviated trachea, | **Blunt chest trauma, shortness of breath, asymmetric lung sounds, deviated trachea, crepitance, hypotension | ||
*Hemodynamically unstable | *Hemodynamically unstable | ||
Revision as of 15:19, 17 June 2019
Indications
- Suspected tension pneumothorax needing immediate decompression
- Blunt chest trauma, shortness of breath, asymmetric lung sounds, deviated trachea, crepitance, hypotension
- Hemodynamically unstable
Equipment Needed
- 14 to 16 gauge IV needle/catheter
- 5 or 10mL syringe
Procedure
- Insert 14 to 16 gauge IV needle catheter attached to syringe along superior margin of 2nd or 3rd rib in midclavicular line
- Advance needle until air is aspirated to syringe
- Withdraw needle
- Leave angiocatheter open to air
- Immediate rush of air out of chest = tension pneumothorax
- Follow immediately with standard thoracostomy tube
Complications
- Kinking of catheter
- Dislodgement
- Recurrence of tension pneumothorax
- Lung laceration
- Air embolism
See Also
External Links
References
- Roberts, 179
- Wolfson, 82, 129