01-28-2007, 10:47
|
#16
|
|
Quiet Professional
Join Date: Jan 2004
Location: Wherever my ruck finds itself
Posts: 2,972
|
Needle Thorocentesis doesnt reinflate the lung; its just a tool to buy some time, temporarily relieve the tension from within the thorax, til the patient can be moved to a safer location, or one more suited for placing chest tubes. The definitive treatment is still the tube thorocostomy.
Crip
__________________
"It's better to die on your feet than live on your knees."
"Its not who I am underneath, but what I do that defines me" -Batman
"There are no obstacles, only opportunities for excellence."- NousDefionsDoc
|
|
Surgicalcric is offline
|
|
|
01-28-2007, 11:07
|
#17
|
|
Guerrilla Chief
Join Date: Jul 2004
Location: Phoenix, AZ
Posts: 880
|
Quote:
|
Originally Posted by Surgicalcric
Needle Thorocentesis doesnt reinflate the lung; its just a tool to buy some time, temporarily relieve the tension from within the thorax, til the patient can be moved to a safer location, or one more suited for placing chest tubes. The definitive treatment is still the tube thorocostomy.
Crip
|
Unless you are on positive pressure, i.e., a ventilator or are being bagged via an endo tracheal tube....another reason I like the one way valves we use (walmart fish tank) to not allow air back in once it escapes the pleural cavity. Most people tolerate a simple pneumothorax very well....don't like it for long periods of time, but generally can maintain adequate oxygenation and ventilation for awhile...it's the tension that gets you. We carry a Cook wire wrapped decompression neeedle since the standard jelco 16 G 5cm needles love to bend and kink...we teach and preach, once decompressed, re-eval and if ANY changes to RR, HR, BP, decompress again....and again....and again.
ss
__________________
'Revel in action, translate perceptions into instant judgements, and these into actions that are irrevocable, monumentous and dreadful - all this with lightning speed, in conditions of great stress and in an environment of high tension:what is expected of "us" is the impossible, yet we deliver just that.
(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.
The blade is so sharp that the incision is perfect. They don't realize they've been cut until they're out of the fight: A Surgeon Warrior. I use a knife to defend life and to save it. ss (aka traumadoc)
|
|
swatsurgeon is offline
|
|
|
01-28-2007, 20:24
|
#18
|
|
Quiet Professional
Join Date: Jan 2004
Location: Wherever my ruck finds itself
Posts: 2,972
|
Quote:
|
Originally Posted by swatsurgeon
Unless you are on positive pressure, i.e., a ventilator or are being bagged via an endo tracheal tube....another reason I like the one way valves we use (walmart fish tank) to not allow air back in once it escapes the pleural cavity. Most people tolerate a simple pneumothorax very well....don't like it for long periods of time, but generally can maintain adequate oxygenation and ventilation for awhile...it's the tension that gets you. We carry a Cook wire wrapped decompression neeedle since the standard jelco 16 G 5cm needles love to bend and kink...we teach and preach, once decompressed, re-eval and if ANY changes to RR, HR, BP, decompress again....and again....and again.
ss
|
Maybe I should have prefaced my previous with, "in the field," or "under fire." 
Crip
__________________
"It's better to die on your feet than live on your knees."
"Its not who I am underneath, but what I do that defines me" -Batman
"There are no obstacles, only opportunities for excellence."- NousDefionsDoc
|
|
Surgicalcric is offline
|
|
|
01-28-2007, 21:38
|
#19
|
|
Guest
|
SFQC After pneumothorax
Check AR 40-501 (google for it). If it has been surgically repaired over three years ago then it would not be disqualifying. Asuming you only had only one.
|
|
|
|
|
01-28-2007, 22:37
|
#20
|
|
Guerrilla
Join Date: Jan 2004
Location: Nevada
Posts: 213
|
Quote:
|
Originally Posted by swatsurgeon
Unless you are on positive pressure, i.e., a ventilator or are being bagged via an endo tracheal tube....another reason I like the one way valves we use (walmart fish tank) to not allow air back in once it escapes the pleural cavity. Most people tolerate a simple pneumothorax very well....don't like it for long periods of time, but generally can maintain adequate oxygenation and ventilation for awhile...it's the tension that gets you. We carry a Cook wire wrapped decompression neeedle since the standard jelco 16 G 5cm needles love to bend and kink...we teach and preach, once decompressed, re-eval and if ANY changes to RR, HR, BP, decompress again....and again....and again.
ss
|
10G with a flapper valve is what we would use. Obviously the proper definitive treatment is a chest tube, and we carried those as well. With a 1 way valve on a chest tube, why would you clamp it off? The doctors that taught me how to do the procedure said clamping is a bad thing...
|
|
TF Kilo is offline
|
|
|
01-29-2007, 13:33
|
#21
|
|
Guerrilla Chief
Join Date: Jul 2004
Location: Phoenix, AZ
Posts: 880
|
Quote:
|
Originally Posted by TF Kilo
10G with a flapper valve is what we would use. Obviously the proper definitive treatment is a chest tube, and we carried those as well. With a 1 way valve on a chest tube, why would you clamp it off? The doctors that taught me how to do the procedure said clamping is a bad thing...
|
clamping is a bad thing...the fish valve is for the 10G needle.
__________________
'Revel in action, translate perceptions into instant judgements, and these into actions that are irrevocable, monumentous and dreadful - all this with lightning speed, in conditions of great stress and in an environment of high tension:what is expected of "us" is the impossible, yet we deliver just that.
(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.
The blade is so sharp that the incision is perfect. They don't realize they've been cut until they're out of the fight: A Surgeon Warrior. I use a knife to defend life and to save it. ss (aka traumadoc)
|
|
swatsurgeon is offline
|
|
|
01-29-2007, 15:55
|
#22
|
|
Guerrilla
Join Date: Nov 2006
Location: Ohio, West Virginia
Posts: 137
|
Quote:
|
Originally Posted by TF Kilo
With a 1 way valve on a chest tube, why would you clamp it off? The doctors that taught me how to do the procedure said clamping is a bad thing...
|
The CT is clamped in preparation for removal, usually a few days after placement. By clamping it, you can get a repeat chest x-ray and see if the pneumo is growing again. If it isn't, the CT can be safely removed.
'zilla
__________________
You may find me one day dead in a ditch somewhere. But by God, you'll find me in a pile of brass. -Tpr. M. Padgett
|
|
Doczilla is offline
|
|
|
01-29-2007, 22:33
|
#23
|
|
Guerrilla
Join Date: Jan 2004
Location: Nevada
Posts: 213
|
You learn something any day... So you clamp it for a period prior to reassessment... ok, cool  Makes sense.
They probably just told us never to clamp it solely because for all intents and purposes, clamping would be counterproductive in our level of care. We aren't doing Xrays to make sure it's working, we just hope to hear the flutter valve sound like a birthday kazoo and our patient be able to breath again.
Thanks!
|
|
TF Kilo is offline
|
|
|
Currently Active Users Viewing This Thread: 1 (0 members and 1 guests)
|
|
|
Posting Rules
|
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts
HTML code is Off
|
|
|
All times are GMT -6. The time now is 20:11.
|
|
|
Linear Mode
