List Archives

Tue Sep 16 11:20:24 BST 2008

I for one would be interested in hearing how often this really occurs.
Blood venting from the anterior chest in a supine patient suggests one
hell of a lot of hemorrhage.  Assuming that it was placed properly, your
catheter thus represents the least of this patient's problems (or
solutions).  Frankly, the mess isn't worth the clinical effect.  Pull
the cath and drive faster.

If on the other hand you've struck vessel (umm, eek), then let's
remember that high-volume phlebotomy is a bad thing.  Again, though, I'd
like to have some idea of the real-world, first-hand experience.  I
expect that these anecdotes are largely the stuff of prehospital
folklore.

Look at it this way: the indication for needle decompression is tension
pneumothorax.  Blood is therefore a clue that either your assessment or
your technique is in error.  Abort, make note, and move on.

Pret Bjorn, RN
Bangor, ME USA

-----Original Message-----
From: trauma-list-bounces at trauma.org
[mailto:trauma-list-bounces at trauma.org] On Behalf Of Sahaj Khalsa
Sent: Tuesday, September 16, 2008 12:48 AM
To: Trauma &amp, Critical Care mailing list
Subject: Needle Decompression

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
--
trauma-list : TRAUMA.ORG
To change your settings or unsubscribe visit:
http://www.trauma.org/index.php?/community/

List Archives

For your convenience, find the Trauma List Archive Below

Needle Decompression