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PHTLS, Ground EMS, Air EMS, Chest Tubes

KMATTOX at aol.com KMATTOX at aol.com
Sun Apr 16 17:09:13 BST 2006

In a message dated 4/16/2006 10:57:20 A.M. Central Standard Time,  
xg2k2 at yahoo.com writes:

That's  definitely fairly disturbing. Do you know if they were attempting a 
gastric  intubation with a chest tube and missed, or were they trying to 
intubate the  chest?

-Mike F

Mike:   I have seen tubes, needles and trocars unwittingly put  into every 
organ of the chest, and most in the upper abdomen, put in by persons  who 
thought they were doing the right thing at the right time.   In  retrospect almost 
none of these iatrogenic emergency procedures were  necessary.   I think I told 
this list of a similar recent mishap from  an attempted needle decompression 
of what was thought by the paramedic to be a  tension pneumothorax.  The 
patient had a fatal iatrogenically produced  needle injury to the lung.  At surgery 
and at autopsy, there was complete  chronic adhesion of the lung to the chest 
wall.  There was NO WAY the  patient could have had a tension pneumothorax.   
In my view much more  harm is done attempting to do heroic procedures in the 
field than I have  ever found to be beneficial.   Chest tubes and needles into 
the  pleural cavity in the field just should not be done in my opinion.  

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