SpecialK
Forum Captain
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Basically, don't piss arse around and bloody well decompress it, with the understanding for a tension pneumothorax to be present the patient must have shock and this must be rapid and progressive, a "little of shortness of breath and tachycardia" doesn't equal tension pneumothorax.
Traditionally we've used been with a very long cannula but those days are over, bam, goneburger. Finger or tube thoracostomy is where it is now at. I've seen the HEMS Docs use a short chest tube with a one way valve of about six inches in length; do a traditional finger thoracostomy, insert it and sew it in with a few sutures. The only downside to finger thoracostomy is it hurts, like a lot, but no major, use some SC 1% lignocaine plain and little bit ketamine and you'll be sweet.
As for ventilation? No difference really.
Traditionally we've used been with a very long cannula but those days are over, bam, goneburger. Finger or tube thoracostomy is where it is now at. I've seen the HEMS Docs use a short chest tube with a one way valve of about six inches in length; do a traditional finger thoracostomy, insert it and sew it in with a few sutures. The only downside to finger thoracostomy is it hurts, like a lot, but no major, use some SC 1% lignocaine plain and little bit ketamine and you'll be sweet.
As for ventilation? No difference really.