Needle Thoracostomy; Needle Chest Decompression Procedure for Tension Pneumothorax скачать в хорошем качестве

Needle Thoracostomy; Needle Chest Decompression Procedure for Tension Pneumothorax

NEEDLE CHEST DECOMPRESSION CRITERIA: • Signs and symptoms of a tension pneumothorax. CONTRAINDICATIONS: • None EQUIPMENT: • Adult Patients and Pediatric Patients greater than or equal to 60 kg: SPEAR Needle with included one-way valve • Pediatric Patients less than 60 kg: 18 gauge, 2” IV catheter • Chlorhexidine wipes • Stethoscope PROCEDURE: 1. Prepare equipment. 2. Locate 2nd or 3rd intercostal space at mid-clavicular line on affected side of chest. A. Alternative placement site is the 4th or 5th intercostal space at the anterior axillary line. 3. Prepare area with Chlorhexidine. 4. With SPEAR needle scalpel tip, create a 0.5 cm incision in the skin at the insertion site. 5. Insert needle into skin and adipose tissue until contact is made with the rib. 6. Measure and hold the needle at 3 cm above the skin (see picture below), THEN 7. Insert needle catheter assembly ≤3 cm total depth and perpendicular to the chest, directing it just over the rib. 8. Guiding catheter cranially (towards the head), advance catheter over the needle without further advancing needle. Remove the needle. 9. Attach the one-way valve (include on SPEAR needle assembly) to the hub of the catheter. 10. Secure the assembly to the chest wall with tape. 11. Auscultate chest for improvement in breath sounds. 12. Monitor catheter and valve to ensure continued correct functioning, and reevaluate patient for additional decompression. CONSIDERATIONS: • Frequently reassess breath sounds and blood pressure. • Repeat procedure as indicated. • For pediatric patients less than 60 kg, use standard technique with IV catheter being mindful of insertion depth. Disclaimer: While we welcome viewers from other EMS systems and the general public, please note that the content in these videos is intended primarily for internal use within HCEC. The procedures and guidelines presented should not supersede any other department's local or regional medical direction. Additionally, all human cadavers used in these demonstrations have been ethically sourced and treated with the utmost respect, in compliance with all relevant laws and ethical guidelines.