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Tue Sep 16 15:49:50 BST 2008

Dr. Mattox I would suspect that a needle decompression is of lesser benefit
for yourself as a Trauma Surgeon with your armament of knowledge and skill
available, yet with all due respect the benefit of a needle decompression in
the prehospital setting has allowed many a surgeons to quote/unquote, "save
the patient."  In my career I have and have seen several such situations
that the needle decompression made the difference in transferring a viable
patient to the ED/Trauma Center versus delivering a trauma arrest.  This
includes one that a surgeon argued the decompression was inappropriate,
pulled out my set-up, and then had to lead the resuscitation while a proper
chest tube was placed.  The point that seems to frequently forgotten is that
the prehospital, the ED/Trauma Center, and the OR are different environments
and significantly different resource pools.  What may be questionable or
inappropriate in one environment maybe the positive "difference" in a
person's life in another.   

Take care,

Bob

307 920 2020
-----Original Message-----
From: trauma-list-bounces at trauma.org [mailto:trauma-list-bounces at trauma.org]
On Behalf Of kmattox at aol.com
Sent: Tuesday, September 16, 2008 8:21 AM
To: Trauma &amp; Critical Care mailing list
Subject: Re: Needle Decompression

I for one have never been impressed, nor seen real benefit from needle
decompression of the chest.   

K

------Original Message------
From: Dr Ross Hofmeyr
Sender: trauma-list-bounces at trauma.org
To: 'Trauma &amp; Critical Care mailing list'
ReplyTo: Trauma &amp; Critical Care mailing list
Sent: Sep 16, 2008 9:04 AM
Subject: RE: Needle Decompression

> You put 
> in in for proper indications ( decreased breath sounds, 
> decreased oxygenation) then is doing its job allowing the 
> lung to expand (blood or air they both can compress the 
> lung).

*Screeches to halt*

Holdonamminit - how, pray tell, does a cannula in the chest help the lung
expand?  Do you mean a cannula PLUS non-return valve of some form?

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Needle Decompression