2015 Trumbull Memorial Hospital Demo

Chest Decompression Chest Decompression

Steps

Performed? Yes No

1. Assess for clinical indications

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 Progressive severe respiratory distress and/or cyanosis  Hyperresonance on percussion of the affected area  Tracheal shift away from the affected side  Distended neck veins  Hypotension

 Suddenly difficulty when attempting to ventilate the patient  Reduced or absent breath sounds over the affected lung 2. Administer 100% Oxygen to patients with suspected tension pneumothorax 3. Expose entire chest area and clean the site vigorously with an antibacterial/antiseptic wipe. Prepare large bore over-the-needle catheter, 14 gauge or larger (16-18 gauge for children) with 10mL or larger syringe with 3-4 mL of fluid attached via PRN extension set. 4. Insert catheter into the second intercostal space on the midclavicular line while withdrawing the plunger of the syringe. Ensure that the needle slides over the top of the third rib until it reaches the parietal space. Air bubbles will enter the syringe when the needle is at the appropriate depth. 5. Once depth is confirmed, insert catheter and withdraw needle. If air is under tension, it will exit under pressure. 7. With a simple or open pneumothorax that shows no signs of tension, needle thoracentesis is of no value and may be harmful! Continuously reassess adequacy of ventilation. 8. When possible, leave syringe attached to catheter via PRN adapter extension set and secure the syringe to the patient’s chest. Withdraw air as needed to prevent further tension pneumothoraces. 6. If no air is obtained, leave the catheter in place with syringe attached, and secure.

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120

EMR

EMT

AEMT

Paramedic

Extended