Needle thoracostomy: Difference between revisions

(8 intermediate revisions by 5 users not shown)
Line 1: Line 1:
==Indications==
==Indications==
* Suspected [[tension pneumothorax]] needing immediate decompression
*Suspected [[tension pneumothorax]] needing immediate decompression
* Hemodynamically unstable
**Blunt chest trauma, shortness of breath, asymmetric lung sounds, deviated trachea, crepitance, hypotension
*Hemodynamically unstable


==Equipment Needed==
==Equipment Needed==
* 14 to 16 gauge IV needle/catheter
*14 to 16 gauge IV needle/catheter
* 5 or 10mL syringe
*5 or 10mL syringe
 
==Procedure==
==Procedure==
* Insert 14 to 16 gauge IV needle catheter attached to syringe along superior margin of 2nd or 3rd rib in midclavicular line
*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
*Advance needle until air is aspirated to syringe
* Withdraw needle
*Withdraw needle
* Leave angiocatheter open to air
*Leave angiocatheter open to air
* Immediate rush of air out of chest = tension pneumothorax
*Immediate rush of air out of chest = tension pneumothorax
* Follow immediately with standard thoracostomy tube
*Follow immediately with standard thoracostomy tube
 
==Complications==
==Complications==
* Kinking of catheter
*Kinking of catheter
* Dislodgement
*Dislodgement
* Recurrence of tension pneumothorax
*Recurrence of [[tension pneumothorax]]
* Lung laceration
*[[Lung laceration]]
* Air embolism
*[[Air embolism]]
 
==See Also==
==See Also==
*[[Thoracic trauma]]
*[[Tension pneumothorax]]
*[[Pneumothorax]]
*[[Finger Thoracostomy]]


==External Links==
==External Links==


==Sources==


==References==
*Roberts, 179
*Wolfson, 82, 129
<references/>
<references/>
*Doelken P, et al. Placement and management of thoracostomy tubes. In: Post T, ed. UpToDate. Waltham, Mass.: UpToDate; 2014. www.uptodate.com. Accessed December 25, 2014. 
 
[[Category:Procedures]]
[[Category:Procedures]]

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

See Also

External Links

References

  • Roberts, 179
  • Wolfson, 82, 129