Needle thoracostomy

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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