Difference between revisions of "Needle thoracostomy"

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==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]]
 +
*[[shock|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]]
 +
[[Category:Critical Care]]
 +
[[Category:Pulmonary]]

Latest revision as of 16:39, 9 October 2019

Indications

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