03-01-2005, 19:40
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#1
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Quiet Professional
Join Date: Jan 2004
Location: Fort Bragg, NC
Posts: 184
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Remind me again please
When do you use a needle decompression and when do you use a chest tube? Memory says that they are both used to releave air trapped in the chest cavity between the lungs and the ribs. So it seems to me that the chest tube can remove air faster then the needle. I am sure I am missing something, just don't know what or I am just completely wrong.
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We have before us an ordeal of the most grievous kind. We have before us many, many long months of struggle and of suffering. You ask what is our policy? I will say: It is to wage war, by sea, land, and air with all our might and all our strength that God can give us; to wage war against a monstrous tyranny, never surpassed in the dark, lamentable catalogue of human crime. That is our policy. You ask, What is our aim? I answer in one word: Victory Victory at all costs, victory in spite of all terror, victory, however long and hard the road may be; for without victory, there is no survival. Winston Churchill
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Para is offline
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03-01-2005, 20:11
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#2
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Quiet Professional
Join Date: Jan 2004
Location: Colorado Springs
Posts: 4,546
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What, did you go and piss off your team's 18D again, so he won't tell you? 
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Razor is offline
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03-01-2005, 20:22
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#3
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Quiet Professional
Join Date: Jan 2004
Location: Fort Bragg, NC
Posts: 184
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The entire Battalion is out of state training and unavailable while I await the birth of my first child.
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We have before us an ordeal of the most grievous kind. We have before us many, many long months of struggle and of suffering. You ask what is our policy? I will say: It is to wage war, by sea, land, and air with all our might and all our strength that God can give us; to wage war against a monstrous tyranny, never surpassed in the dark, lamentable catalogue of human crime. That is our policy. You ask, What is our aim? I answer in one word: Victory Victory at all costs, victory in spite of all terror, victory, however long and hard the road may be; for without victory, there is no survival. Winston Churchill
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Para is offline
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03-01-2005, 20:29
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#4
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Consigliere
Join Date: Jan 2004
Location: Free Pineland (at last)
Posts: 8,845
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Quote:
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Originally Posted by Para
The entire Battalion is out of state training and unavailable while I await the birth of my first child.
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Congrats, Para! Enjoy the time you can spend with the kid -- they grow up fast.
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Roguish Lawyer is offline
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03-01-2005, 20:47
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#5
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Quiet Professional
Join Date: Jan 2004
Location: LA
Posts: 1,653
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Excellent question! 
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NousDefionsDoc is offline
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03-01-2005, 21:51
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#6
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Quiet Professional
Join Date: Jan 2004
Location: Free Pineland
Posts: 24,829
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Quote:
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Originally Posted by Para
The entire Battalion is out of state training and unavailable while I await the birth of my first child.
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Early congrats!
TR
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"It is not the critic who counts; not the man who points out how the strong man stumbles, or where the doer of deeds could have done them better. The credit belongs to the man who is actually in the arena, whose face is marred by dust and sweat and blood; who strives valiantly; who errs, who comes short again and again, because there is no effort without error and shortcoming; but who does actually strive to do the deeds; who knows great enthusiasms, the great devotions; who spends himself in a worthy cause; who at the best knows in the end the triumph of high achievement, and who at the worst, if he fails, at least fails while daring greatly, so that his place shall never be with those cold and timid souls who neither know victory nor defeat." - President Theodore Roosevelt, 1910
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The Reaper is offline
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03-01-2005, 22:26
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#7
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JAWBREAKER
Join Date: Jan 2004
Location: Gulf coast
Posts: 1,906
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Early Congrats Para....
A needle is used for a VERY quick decompression in a critical situation and could be used as a emergency diagnostic confirmation during a field type situation when no chest xray is available and before you cut in a chest tube. You literally hear the air release once your gain access to that pleural space and in my VERY limited experience get very quick and affirmative results with the patient if you were (a) successful and (b) it was needed and they actually had a tension pneumo. LOL
I've been at the table and assisted while my son was needled twice to relieve a tension pneumo with critical symptoms of pronounced tracheal shift, diminished breath sounds, very low 02 sats even while being ventilated on 100% 02, bradycardia, yet plenty of blood volume (he did not display JVD but if the patient does have JVD- it does alert you that there is not a volume deficiency causing the shock and helps diagnose TP) while a chest tube setup was obtained. Chest tube w/suction unit was the permanent treatment for his condition.
NOTE: Please wait for SwatSurgeon or DocT to chime in on this. They are trauma surgeons and true experts. 
Last edited by Sacamuelas; 03-01-2005 at 22:43.
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Sacamuelas is offline
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03-02-2005, 08:01
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#8
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Guerrilla Chief
Join Date: Jul 2004
Location: Phoenix, AZ
Posts: 880
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Saca is correct...let me add one thing....tracheal deviation, low blood pressure are 'later' signs of tension PTX. If the patient has the signs or symptoms that make you even THINK that the patient has a PTX, just decompress it.....this is the VAIL RULE #1: if you think it, do it...when it comes to decompression or intubation. The worst they do is now buy a chest tube.
The free and open space created by the needle, decompresses the tension component but can give a simple PTX that can compromise some people....hence why I like those little one way valves I showed in another thread. Air gets out and can't rush back in.
If someone gets needle decompressed and decompensates, intubation or just providing positive pressure ventilation will expand the lung but damn, we breath by negative pressure ventilation without assistance.
Chest tubes are not a front line item, but a 10 or 12 gauge wire wrapped needle and a one way valve is just as good as a chest tube IMHO
Just use search: for fish tank valve and the thread will be there, I can't link it for some reason
http://www.professionalsoldiers.com/...ish+tank+valve
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(adapted from: Sherwin B. Nuland, MD, surgeon and author: The Wisdom of the Body, 1997 )
Education is the anti-ignorance we all need to better treat our patients. ss, 2008.
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Last edited by Sacamuelas; 03-02-2005 at 09:11.
Reason: added link for you
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