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Needle thoracostomy
From WikEM
Contents
Indications
- Suspected tension pneumothorax needing immediate decompression
- Hemodynamically unstable
Equipment Needed
- 14 to 16 gauge IV needle/catheter
- 5 or 10mL syringe
Procedure
- Insert 14 to 16 gauge IV needle catheter attached to syringe along superior margin of 2nd or 3rd rib in midclavicular line
- Advance needle until air is aspirated to syringe
- Withdraw needle
- Leave angiocatheter open to air
- Immediate rush of air out of chest = tension pneumothorax
- Follow immediately with standard thoracostomy tube
Complications
- Kinking of catheter
- Dislodgement
- Recurrence of tension pneumothorax
- Lung laceration
- Air embolism
See Also
External Links
References
- Doelken P, et al. Placement and management of thoracostomy tubes. In: Post T, ed. UpToDate. Waltham, Mass.: UpToDate; 2014. www.uptodate.com. Accessed December 25, 2014.
