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Richard Wigle MD FACS FCCM rlwigle at yahoo.com
Fri Aug 14 16:45:00 BST 2015

it would seem to me that if you have converted an open pneumothorax to a tension pneumothorax with your dressing you simply take the dressing down and relieve the tension
I have never understood all the worrying about a 3 sided dressing, seems like a lot of fiddling being done in a critical patient
 Richard L Wigle MD FACS FCCM 

     On Friday, August 14, 2015 8:28 AM, Greg Chapman <chapmgre1 at gmail.com> wrote:

 So the question at hand is in a open (sucking) chest wound what would work
best.  Some recent data from the military suggests that the application of
a non-vented chest seal (or three sided dressing that has malfunctioned)
can actually do more harm than no care at all.  If you take a simple
pneumothorax and turn it into a tension by placing an occlusive dressing
have we provided good patient care?

Greg Chapman BS.,RRT, REMT-P
Director, Center for Prehospital Medicine
Carolinas Medical Center
Charlotte NC

On Fri, Aug 14, 2015 at 8:41 AM, Charles Krin <cskrin2 at hughes.net> wrote:

> I don't know about McSwain's Dart, but I understand that the failure
> rate of needle decompression is rather high...through a combination of
> adverse anatomy and diagnostic problems.
> Chuck
> On 8/14/2015 07:20, Robert Smith wrote:
> > Is there  a difference in empyema rate or other complication rates chest
> tube vs. needle decompression?
> >
> >
> > Robert F. Smith MD, MPH
> > Cook County Trauma (ret)
> >
> >> On Aug 14, 2015, at 7:03 AM, Charles Krin <cskrin2 at hughes.net> wrote:
> >>
> >> I agree with Larry, but also pointed out that it is NOT something US
> >> paramedics are routinely educated and trained to handle, nor something
> >> that generally falls under a paramedic scope of practice to the best of
> >> my knowledge.
> >>
> >> And as more military medics transition back to civilian life, it will be
> >> interesting to see how it affects the National Registry and other
> >> Paramedic certifying groups. It is nice that most of the military medics
> >> are now able to test for appropriate NR levels (something that was not
> >> directly available when I was enlisted back in the early 1980s), but
> >> medics and corpsmen have been able to do *many* more procedures than
> >> their civilian counterparts, at least on other military members.
> >>
> >> Chuck
> >>
> >>
> --
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