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Clamp the the chest tube in an EMS placed chest tube

Bjorn, Pret pbjorn at emh.org
Fri Apr 7 20:33:52 BST 2006


-----Original Message-----
From: kokaramc at bellsouth.net [mailto:kokaramc at bellsouth.net] 
Sent: Friday, April 07, 2006 2:47 PM
To: Trauma & Critical Care mailing list
Subject: Re: Re: Clamp the the chest tube in an EMS placed chest tube


" ...for every 500ml of blood out of the chest tube, mortality significantly
increases..."

Then for crying out loud, what are you letting all that blood out for?   :]

" ...(Prehospital EMS) cant totally verify a PTX/HTX without an xray... " 

Waitwaitwait -- you recommend an x-ray before treating tension pneumothorax?
That's the only indication for prehospital thoracostomy, at least where I
work.

" ...and we sort of see enough PTX already caused by unnecessary needle
decompressions in the field."

Honest?  What are your sort of numbers?  

I admit I've seen a few unjustifiable needlings; but I can't recall a
significant needle-related injury -- certainly nothing to force to
eliminating the option.  In rural America, tension pneumo isn't an injury
which tolerates neglect.


Pret Bjorn, RN
Bangor, ME USA


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