Re: @SPAM+++++++++ Re: Chest decompression.

[Guest guest]

No actual need for any home made flutter valve on the end because the

intra-thoracic negative pressure on inhalation will draw air through the much

larger Trachea as opposed to the miniature catheter opening (Ohms Law in

reverse)

Just stick the catheter in and either secure with an Asherman Chest Seal if your

rich to hold the catheter in place or the better and cheaper option is to simply

place your plaster tape real over the end of the catheter and tape it down so

the lumen of the tube holds the catheter in place without kinking (toilet role

tube idea).

After needle thoracocentesis the only other intervention that should be consider

in an immediate phase is the " Simple Thoracocentesis " as referred to by London

HEMS. Simply make the incision for a chest tube but leave it at that.

Takes way less time which most prehospital medics don't have much of and as with

Needle Thoracocentesis we are only interested in relieving a bit of pressure to

prevent a life threatening tension.

The rest can be done later.

Jon

@SPAM+++++++++ Re: Chest decompression.

Using a 14G IV Cannula between 2nd and 3rd rib mid

clavicular line works well, once in remove needle

leaving plastic cath. Using condom or glove finger as

a valve works well. Can also use a small fish tank

valve, fits neatly into end of catheter and works

well.

Midclavicular is excellent position as easy access

with patient lying flat on back or spinal immobilised.

--- Rod Eglin <rod@...> wrote:

> Hi all

>

> A friend of mine & I were having a chat about the

> above subject & we thought

> we would ask the guys out in " the big video game "

> what methods they used for

> decompressing a Tension Pnuemothorax and what

> results you have had with:

>

>

> MacSwain Dart?

> Asherman Seals with one way valve?

> Chest Tube with Hyemlick.

> 10 gauge Cath with a Condom (good trick)

> Others?

> Cheers

>

> Rod

>

>

__________________________________________________

[Guest guest]

Keep in mind that, regardless of the technique you

use, probably the most important thing is to have a

needle that's long enough. There have been a few cat

scan based case series and one cadaver series that

demonstrate on what is becoming a normal sized adult

(at least in the US), any catheter shorter than 4

inches isn't making it through all the tissue.

There's also no evidence that needle thoracentesis (or

tube throacentesis) makes in impact on outcome but of

the three patient's I've needled in the field, one was

DRT (dead right there) anyway, one was dead but his

body didn't know it, and the other, with isolated

chest trauma (GSW), got better and lived to commit

another felony.

Jonnathan

--- Jon <jon@...> wrote:

> No actual need for any home made flutter valve on

> the end because the intra-thoracic negative pressure

> on inhalation will draw air through the much larger

> Trachea as opposed to the miniature catheter opening

> (Ohms Law in reverse)

>

> Just stick the catheter in and either secure with an

> Asherman Chest Seal if your rich to hold the

> catheter in place or the better and cheaper option

> is to simply place your plaster tape real over the

> end of the catheter and tape it down so the lumen of

> the tube holds the catheter in place without kinking

> (toilet role tube idea).

>

> After needle thoracocentesis the only other

> intervention that should be consider in an immediate

> phase is the " Simple Thoracocentesis " as referred to

> by London HEMS. Simply make the incision for a chest

> tube but leave it at that.

>

> Takes way less time which most prehospital medics

> don't have much of and as with Needle

> Thoracocentesis we are only interested in relieving

> a bit of pressure to prevent a life threatening

> tension.

>

> The rest can be done later.

>

> Jon

> @SPAM+++++++++ Re:

> Chest decompression.

>

>

> Using a 14G IV Cannula between 2nd and 3rd rib mid

> clavicular line works well, once in remove needle

> leaving plastic cath. Using condom or glove finger

> as

> a valve works well. Can also use a small fish tank

> valve, fits neatly into end of catheter and works

> well.

> Midclavicular is excellent position as easy access

> with patient lying flat on back or spinal

> immobilised.

>

> --- Rod Eglin <rod@...> wrote:

>

> > Hi all

> >

> > A friend of mine & I were having a chat about

> the

> > above subject & we thought

> > we would ask the guys out in " the big video

> game "

> > what methods they used for

> > decompressing a Tension Pnuemothorax and what

> > results you have had with:

> >

> >

> > MacSwain Dart?

> > Asherman Seals with one way valve?

> > Chest Tube with Hyemlick.

> > 10 gauge Cath with a Condom (good trick)

> > Others?

> > Cheers

> >

> > Rod

> >

> >

>

>

> __________________________________________________

>