Needle thoracostomy

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Indications

  • Suspected tension pneumothorax needing immediate decompression
  • 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

Sources

  • 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.