LANDMARKS AND PROCEDURE FOR DECOMPRESSION OF A TENSION PNEUMOTHORAX
- Confirm the need for Needle Decompression:
- a. Respiratory distress
- cyanosis; and/or
- chest pain.
- b. Absent or decreased breath sounds on the affected side; and
- c. A deviated trachea away from the side of the injury.
- Administer high concentration oxygen.
- Identify the second intercostal space on the mid-clavicular line on the same side as the pneumothorax.
- Cleanse the overlying skin with Povidone Iodine solution.
- Insert a #14 gauge, 3-6 cm long, over-the-needle catheter into the skin above the third rib and direct it just over the rib into the interspace.
- Insert the catheter through the parietal pleura until air exits under pressure.
- Remove the needle and leave the plastic cannula in place until it is replaced in the Emergency Department.
- Attach a flutter valve to the end of the plastic cannula and secure the cannula for transportation.