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Clamp the the chest tube in an EMS placed chest tube

docrickfry at aol.com docrickfry at aol.com
Fri Apr 7 22:03:37 BST 2006


That's when in the hospital Pret--review the ATLS manual and see if you see a single word or patient scenario in which the patient should or did get such intervention in the field.  I actually would not have any problem with doing a needle in the field for a clinical diagnosis of a true tension PTX with shock--the problem is, it never happens--needles are stuck all over patients (I had one in the liver a few weeks ago) because of reasons like "I couldn't hear good breath sounds" or "he complained of difficulty breathing" or "he had a bruise on his chest" etc all with normal vital signs.  There seems no control over the criteria used for needling in the field and surprisingly little understanding of why they are or should be doing this.  In reading posts on this list over a few years, such seems true everywhere.
ERF
ERF
 
-----Original Message-----
From: Bjorn, Pret <pbjorn at emh.org>
To: 'Trauma &amp; Critical Care mailing list' <trauma-list at trauma.org>
Sent: Fri, 7 Apr 2006 16:20:36 -0400 
Subject: RE: Clamp the the chest tube in an EMS placed chest tube


Who's gonna tell ATLS?  

By the book, tension pneumo is a clinical diagnosis, and treated by
immediate needle thoracostomy.  

Do we assume that this is only an urban phenomenon?

Pret

-----Original Message-----
From: KMATTOX at aol.com [mailto:KMATTOX at aol.com] 
Sent: Friday, April 07, 2006 3:47 PM
To: trauma-list at trauma.org
Subject: Re: Clamp the the chest tube in an EMS placed chest tube


 
In a message dated 4/7/2006 2:34:36 P.M. Central Standard Time,  
pbjorn at emh.org writes:

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




NOPE.   This is an old wives tail, and an urban  legend.   Either give some 
real data to support it or just stop doing  it.   Most of the country and
the 
world is NOT doing this  foolishness.  
 
k
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