{"id":143,"date":"2015-12-07T16:19:40","date_gmt":"2015-12-07T16:19:40","guid":{"rendered":"http:\/\/brooksidepress.org\/surgery\/?page_id=143"},"modified":"2023-08-20T20:42:34","modified_gmt":"2023-08-20T20:42:34","slug":"3-3-needle-decompression-thoracentesis","status":"publish","type":"page","link":"https:\/\/brooksidepress.org\/surgery\/?page_id=143","title":{"rendered":"3-3. NEEDLE DECOMPRESSION (THORACENTESIS)"},"content":{"rendered":"<p>Needle decompression is the removal of air and fluid from the chest cavity by\u00a0puncture. <iframe loading=\"lazy\" src=\"https:\/\/player.vimeo.com\/video\/114098037\" width=\"500\" height=\"375\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><\/p>\n<p>a.<strong> Indications for Needle Decompression<\/strong>. Indications for needle depression include the following.<\/p>\n<p style=\"padding-left: 30px;\">(1) Under combat conditions, if a casualty has unilateral chest trauma and\u00a0an increase in respiratory effort, these are the only conditions needed to indicate the\u00a0need for immediate chest needle decompression.<\/p>\n<p style=\"padding-left: 30px;\">(2) Under more controlled conditions, the following signs and symptoms\u00a0should be observed prior to chest needle decompression.<\/p>\n<p style=\"padding-left: 60px;\">(a) Severe respiratory distress.<\/p>\n<p style=\"padding-left: 60px;\">(b) Jugular vein distention.<\/p>\n<p style=\"padding-left: 60px;\">(c) Hyper resonance on the affected side.<\/p>\n<p style=\"padding-left: 60px;\">(d) Absent or diminished breath sounds on the affected side.<\/p>\n<p style=\"padding-left: 60px;\">(e) Pulseless paradox (the radial pulse fades or disappears upon\u00a0inspiration).<\/p>\n<p style=\"padding-left: 60px;\">(f) Tracheal deviation may be seen, but is considered a very late and\u00a0grave sign.<\/p>\n<p>b. <strong>Procedure for Needle Decompression<\/strong>. Follow this procedure.<\/p>\n<p style=\"padding-left: 30px;\">(1) Confirm the diagnostic need for the needle decompression procedure.<\/p>\n<p style=\"padding-left: 30px;\">(2) Obtain a 14 gauge 3 to 3.5-inch needle.<\/p>\n<p style=\"padding-left: 30px;\">(3) If available, give the patient supplemental oxygen. This is normal\u00a0procedure for a patient in respiratory distress.<\/p>\n<p><em><strong>NOTE: Always provide the optimum condition the situation allows<\/strong><\/em><\/p>\n<p style=\"padding-left: 30px;\">(4) Identify your site (figure 3-4). The primary site is the second intercostal\u00a0space in the midclavicular line. You can alternately use the third through sixth\u00a0intercostal space moving toward the anterior axillary line, making sure to stay clear of\u00a0the major organs, especially on the left side of the chest.<\/p>\n<figure id=\"attachment_271\" aria-describedby=\"caption-attachment-271\" style=\"width: 280px\" class=\"wp-caption aligncenter\"><a href=\"http:\/\/brooksidepress.org\/surgery\/wp-content\/uploads\/2017\/01\/Figure-3-4.-Sites-for-needle-decompression.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-271 size-medium\" src=\"http:\/\/brooksidepress.org\/surgery\/wp-content\/uploads\/2017\/01\/Figure-3-4.-Sites-for-needle-decompression-280x300.jpg\" width=\"280\" height=\"300\" title=\"\" srcset=\"https:\/\/brooksidepress.org\/surgery\/wp-content\/uploads\/2017\/01\/Figure-3-4.-Sites-for-needle-decompression-280x300.jpg 280w, https:\/\/brooksidepress.org\/surgery\/wp-content\/uploads\/2017\/01\/Figure-3-4.-Sites-for-needle-decompression.jpg 527w\" sizes=\"auto, (max-width: 280px) 100vw, 280px\" \/><\/a><figcaption id=\"caption-attachment-271\" class=\"wp-caption-text\">Figure 3-4. Sites for needle decompression<\/figcaption><\/figure>\n<p style=\"padding-left: 30px;\">(5) Anesthetize the area locally if time permits. Remember, this is a lifesaving\u00a0emergency procedure. The patient\u2019s airway is compromised and the chest\u00a0needle decompression is the fix. Do not waste time getting the airway open.<\/p>\n<p style=\"padding-left: 30px;\">(6) Position the patient. You may position him in an upright position if you\u00a0have determined that he does not have a cervical spine fracture.<\/p>\n<p style=\"padding-left: 30px;\">(7) Insert the thoracentesis needle into the skin. Direct the needle just over\u00a0the rib into the intercostal space.<\/p>\n<p style=\"padding-left: 30px;\">(8) Puncture the parietal pleural space.<\/p>\n<p style=\"padding-left: 30px;\">(9) Aspirate as much air as necessary to relieve the patient&#8217;s acute\u00a0symptoms.<\/p>\n<p style=\"padding-left: 30px;\">(10) Leave the plastic catheter in place and apply a bandage or a small\u00a0dressing.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Needle decompression is the removal of air and fluid from the chest cavity by\u00a0puncture. a. Indications for Needle Decompression. Indications for needle depression include the following. (1) Under combat conditions, if a casualty has unilateral chest trauma and\u00a0an increase in respiratory effort, these are the only conditions needed to indicate the\u00a0need for immediate chest needle &hellip; <a href=\"https:\/\/brooksidepress.org\/surgery\/?page_id=143\" class=\"more-link\">Continue reading <span class=\"screen-reader-text\">3-3. NEEDLE DECOMPRESSION (THORACENTESIS)<\/span> <span class=\"meta-nav\">&rarr;<\/span><\/a><\/p>\n","protected":false},"author":2,"featured_media":0,"parent":129,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-143","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/brooksidepress.org\/surgery\/index.php?rest_route=\/wp\/v2\/pages\/143","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/brooksidepress.org\/surgery\/index.php?rest_route=\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/brooksidepress.org\/surgery\/index.php?rest_route=\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/brooksidepress.org\/surgery\/index.php?rest_route=\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/brooksidepress.org\/surgery\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=143"}],"version-history":[{"count":5,"href":"https:\/\/brooksidepress.org\/surgery\/index.php?rest_route=\/wp\/v2\/pages\/143\/revisions"}],"predecessor-version":[{"id":350,"href":"https:\/\/brooksidepress.org\/surgery\/index.php?rest_route=\/wp\/v2\/pages\/143\/revisions\/350"}],"up":[{"embeddable":true,"href":"https:\/\/brooksidepress.org\/surgery\/index.php?rest_route=\/wp\/v2\/pages\/129"}],"wp:attachment":[{"href":"https:\/\/brooksidepress.org\/surgery\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=143"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}