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Trauma - Chest Decompression

Clinical Indications: &= nbsp; &nbs= p; &= nbsp; &nbs= p;

= ______ 1. Tens= ion pneumothorax

= ______ 2. Cons= ider in the setting of refractory pulseless electrical activity (PEA)=

Procedure:

= ______ 1.      Conf= irm the presence of a tension pneumothorax or identify strong clinical evidence= in a rapidly deteriorating patient in the presence of trauma. Consider in the setting of refract= ory PEA.

= ______ 2.      Gath= er and prepare equipment.

= ______ 3.      Loca= te the appropriate insertion site at the second intercostal space at the midclavic= ular line on the affected side of the chest.

= ______ 4.      Prep= the insertion site using an aseptic technique.

= ______ 5.      Inse= rt a 2-inch, 14-gauge angiocath (11/4 inch, 18 gauge angiocath in patients less = than 8 years old) with a 10cc syringe attached.= Direct the needle just over the top of the 3^rd rib (2nd intercostal space) to avoid intercostal nerves and vessels, which are locat= ed on the inferior portion of the rib border.

= ______ 6.      Adva= nce the catheter 1-2 inches (3/4 – 1 inch in patients less than 8 years o= ld) through the chest wall. Pull = back on the plunger of the syringe while inserting. Tension should be felt until the n= eedle enters the plural space. A “pop” or “give” may also be felt. Do not advance the needle any furt= her.

= ______ 7.      Adva= nce the catheter while withdrawing the needle until the catheter is flush with = the skin. Listen for a gush or “hiss” of air, which confirms placement and diagnosis. Caution: This is frequently missed= due to surrounding noise.

= ______ 8.      Disp= ose of needle properly and never reinsert into the catheter.

= ______ 9.      Secu= re the catheter and rapidly transport the patient providing appropriate airway assistance.

= ______ 10. This procedure may be repeated if necessary after frequently reassessing patient status.

= ______ 11. Cont= act medical control and advised of procedure.

= ______ 12. Docu= ment procedure, results and time in the electronic PCR.

Certification Requirements:

Succ= essfully complete a biannual evaluation including the indications, contraindications, technique, and possible complications of the procedure.

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