Needle Decompression

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Hello all,

Many thanks to all of those who have been keeping all of us updated about
their situations during this horrible hurricane season.  I have lots of
family in Houston so I felt like I had a more real and direct line to what
was going on than the news, which was great.  Our thoughts and prayers are
with all of you who are still recovering from all of the devastation.

So I am interested in the opinions of anybody on this list who cares to
share them and has a few spare minutes...

I am a Paramedic and a paramedic instructor and we are trained that when we
decompress a chest (usually with a 14 ga catheter) and get blood flow back,
we should pull the catheter.  Why?

I have discussed this with a number of the ER docs that I work with and
there is no real clear consensus.  Some of them say that I should leave the
catheter in the chest as relieving the pressure is a good thing, whether
that pressure is caused by blood or air.  However, most Paramedic textbooks
advise us to pull it.

Assuming that I have put the dart in correctly (and have not hit the vessels
in the chest wall), understanding that I do not have the capability of
putting in a chest tube and that I am often times more than 60 minutes by
ground from the nearest hospital with no alternative transport (helo)
available, what is your opinion?

Any replies would be appreciated.

Sahaj Khalsa

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