Pneumothorax "what if"

[Thricenotrice]

I have found that you really don't need the flapper over the needle.

Having never done a needle T on a real patient, I have this as a plan as well, just throwing the needle in securing in place without a valve of any sort. Again, never had to do it yet but that's my plan

 

[Veneficus]

Having never done a needle T on a real patient, I have this as a plan as well, just throwing the needle in securing in place without a valve of any sort. Again, never had to do it yet but that's my plan

You don't even need to secure the needle.

If you use the longer 14g and put it in all the way to the hub, it doesn't go anywhere.

 

[Household6]

In a pinch...diaphoretic EKG electrode or AED pad?

I think the "three sided seal" bandage deal is wishful thinking.

That's what we were taught, it came up in discussion last night.

edit: I mean instead of an occlusive..

 

[Brandon O]

Always seemed to me that the inside of a clean (if not sterile) plastic wrapper from... from whatever would make an effective occlusive, if taped properly.

 

[Veneficus]

Always seemed to me that the inside of a clean (if not sterile) plastic wrapper from... from whatever would make an effective occlusive, if taped properly.

They actually make that for surgery.

 

[systemet]

Anybody used a Tegaderm?

I've used these over stab wounds and GSWs, but none that have been true "sucking chest wounds". Of course, these then occlude the wound completely, which is ultimately counterproductive, especially if it doesn't appear to be actively entraining air.

I would think that the wrapper IV bags come in, and some two inch fabric tape would probably work better. This is my new go-to plan, but honestly I don't see a ton of penetrating trauma.

 

[MSDeltaFlt]

If you have a patient that has a pneumothorax due to external trauma, after you put on an occlusive dressing and create a flutter valve (by taping down only 3 sides of the dressing), could you use positive pressure ventilations via a BVM to try and reinflate the lung and push the air back out the hole?

Back on topic, though a bit late, the answer is generally "no". That is unless they are not ventilating well enough on their own. Your flutter valve is treating he pneumo. Your oxygen will treat the associated hypoxia. Your BVM treat any hypercarbia and/or altered level of consciousnrss associated with the pneumo.

Does this make sense?

 

[Mariemt]

A freezer bag is about perfect.

Cut the edges off, use the inside. However, we are within 2 miles of a hospital.

 

[Tigger]

forget the pad, just use the packaging.

Back in the day we just kept sterile aluminum foil of the truck. It worked great.

Still a state requirement in MA!

Per one of our team docs and the paramedic crew, we have a few large (5X9) tegaderms in the red bag in the event of some sort penetrating trauma.

 

[Veneficus]

Still a state requirement in MA!

Don't knock it until you have tried it.

Not sure I think it should be required, but it does work very well.