When a patient present with tension pneumothorax then it is an hand brake and managing the patient like a shot is necessary . Many texts say stress pneumothorax is a clinical diagnosis and treatment can be carried out without any investigation to save the patient role ’s life-time . But if investigating can be done ( e.g. parking brake pectus X - shaft of light ) within in a few min , if the affected role is also hemodynamically stable there is no damage in doing so and this will turn on the doctor to come to a definite diagnosing .
You must be wondering what this needle that we are talking about here . In tension pneumothorax needle thoracostomy / needle decompressing is done as a lifetime pull through step particularly in closed pneumothorax . However , latterly there have been some debate whether phonograph needle thoracostomy is actually an effective mode in saving the patient ’s life . There has not been any conclusion and still needle thoracostomy is done as a lifesaving procedure . Let us see what the equipment needed are and how needle thoracostomy is done .
Where Do You Put The Needle For Tension Pneumothorax?
There have many debates about the anatomical position and distance of the needle because of the bankruptcy rate associated with acerate leaf thoracostomy in tension pneumothorax .
The common practice in tension pneumothorax was to utilise 14 - 16 gauge needle ( an - over the phonograph needle catheter is practiced ) , the length was 5 cm . The anatomic location to slip in the needle was 2nd intercostal quad mid clavicular line .
Recent study have designate that there is a failure rate of 50 - 75 % of needle thoracostomy when a 5 cm needle is used in the 2nd intercostal place mid clavicular line . The late for this failure has been hit the books in clinical field . These study regain out that the pectus paries was pocket-size at the quaternary and 5th intercostal distance anterior alar line , thick at 4th and 5th intercostal space mid axillary parentage and thickest at 2nd intercostal blank space mid clavicular line of reasoning . The reason for needle thoracostomy unsuccessful person is due to the wooden-headed chest wall at the 2nd intercostal space mid clavicular line , therefore a 5 cm phonograph needle could not reach the pleural space . study also have done using dissimilar duration needles and 8 centimeter needle was unremarkably used . However , there was eminent injury rate with the 8 cm needle ( 9 % ) .
Doctors suggest when perform a phonograph needle thoracostomy the patient role ’s BMI , chest wall thickness should also be considered . The needle distance and the anatomical location for the needle placement should be decided wisely .
Procedure
Needle thoracostomy is done in patients who present with tension pneumothorax as a lifesaving procedure . The usual drill was to apply 14 - 16 caliber needle ( an - over the phonograph needle catheter is good ) , the distance was 5 atomic number 96 . The anatomical localization to insert the needle was 2nd intercostal distance mid clavicular line . Due to the in high spirits unsuccessful person rate studies have been done and found out that the chest bulwark was smallest at the quaternary and 5th intercostal blank space anterior alar note , thicker at 4th and 5th intercostal space mid alar origin and thickest at 2nd intercostal space mid clavicular line . When an 8 cm acerate leaf was used the injuries were gamy . Therefore , these studies suggest the best anatomical fix is the fourth or fifth anterior alar stemma with a 5 atomic number 96 phonograph needle .
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