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If you are truly a "couple of hours" out from definitive medical care, then you had better be able to put in a chest tube.
I have lost count of the number of angiocaths EMS has used to "needle" the chest, and then a subsequent CT scan proves they were never within a centimeter of the pleural cavity.... And every time I am solemly assured they got a rush of air...
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Ars Longa, vita brevis
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