Needle Decompression

[mshow00]

To expand the OP a little, those how have experience with both the traditionally decompression kit and the Turkel needle, which do you prefer? When our region changed to the Turkel most of the medics I work with were very unhappy. They did not like the fact of having to use a scaple with the Turkel system. I was wanting something a little more in-depth as to the pros and cons of each. I know that Turkel "needle" is blunted(reason for the scaple) so as not to puncture the lung... I am just looking or a little more info...

[Doczilla]

I have done this procedure many time. It's pretty straightforward.

I have never seen, nor until now heard of, using something called a Turkel needle for this purpose. My google-fu tells me it is a serrated bone biopsy needle.

The thing to know is, if you manage to puncture the lung parenchyma (which you will not do if the patient truly has a tension pneumo), it will make no difference when compared to the lung injury that occurred to create the pneumo in the first place. They are getting a chest tube anyway. The tiny puncture will heal itself without any problem. We get several folks in here that are decompressed by EMS erroneously, and most do fine with observation and without the need for a chest tube.

I have had the distinct honor of initially missing a tension ptx in an ICU patient on a vent (with chest tubes in place bilaterally). Figured it out about 10 minutes into the code when the pre-code chest xray came back.

'zilla

[unknown]

If you see the late sign of tracheal deviation, it's amazing how fast it will straighten up after you do it.

HEY HEY SCRAPPY! You always got the witty thing to say, Oh and YES the river still calls your name, see you Tuesday! 6 of us going so far........

[AZCEP]

I have had the distinct honor of initially missing a tension ptx in an ICU patient on a vent (with chest tubes in place bilaterally). Figured it out about 10 minutes into the code when the pre-code chest xray came back.

Just for the educational opportunity, how did this patient develop a tension pneumo with bilateral chest tubes in place?

Wouldn't the ventilator alarm a high pressure with this?

[firedoc5]

Just for the educational opportunity, how did this patient develop a tension pneumo with bilateral chest tubes in place?

Wouldn't the ventilator alarm a high pressure with this?

That's what I was wondering.

[defib_wizard]

Another thing I have found is patients will sometimes ask you to perform the procedure again. when the catheter occludes and the pressure start to build again.

[Doczilla]

Just for the educational opportunity, how did this patient develop a tension pneumo with bilateral chest tubes in place?

Wouldn't the ventilator alarm a high pressure with this?

Yes, as it also alarms with awake patients on the ventilator who are "fighting" the vent because it is uncomfortable, which he appeared to be doing.

One of the chest tubes clogged. It had been in place for over a week, so there was no reason to suspect that he would get a pneumo at that point. Oddly, the initial presenting issue was paroxysmal SVT. He didn't develop ventilation issues for a good 30 min after that.

Clots can form in chest tubes, preventing them from doing what they need to do (chest tubes have multiple ports in the chest, so it is usually a clot in the tube proximal to the last hole or the tube is wrapped in fibrin). For future reference, I know much better now how to evaluate and test chest tube function.

'zilla

[EMS49393]

Turkel Safety Thorcentesis Catheter

Had them, used them, loved them.

[pamedic152029]

man i did one as a student and i think it hurt me more then the pt...... after i performed it he said he was breathing alittle better but asked me if i was ok! i was scared sh-t less.

[Just Plain Ruff]

bilateral pneumos on a elderly lady circling the drain. Once the needles were in she started to turn around. One of the closest to trauma codes that I've had that have reversed themselves as quickly

I also did on on a ped near resp arrest after he had been shot in the left chest.