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StCEMT

Forum Deputy Chief
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What is yall's experience using bilateral needle decompression before working/not working penetrating traumatic arrest? I've seen my share of patients that were traumatic arrest from GSW's, although the other day was the first that was even a potential candidate for it. They're almost always (mine at least) hemorrhagic. I know there is not a problem with me working it if I think I can correct a problem, but I am wondering if it is worth taking the time to push for a protocol change before we call these just as a general rule of practice.
 

rescue1

Forum Asst. Chief
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Our protocol was to consider needle decompression (uni or bilaterally) before calling it. I think the biggest issue is that a 14G IV cath is not really adequate to treat a hemothorax, even if you place it midaxillary, it's so tiny. It seems like a reasonable step though--needle decompression is probably the most effective ALS trauma intervention that we have and it's probably worth a shot if it's a "fresh" code without an obvious cause of death.

I've only ever personally done bilateral for airway rupture though--it did not work. Finger thoracostomy did, but by then they'd already coded.
 

GMCmedic

Forum Asst. Chief
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We bilaterally decompressed any trauma code with blunt or penetrating trauma. That pretty much left us a lot of wiggle room. Never saw any results from it.
 

KingCountyMedic

Forum Lieutenant
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We called it "The Aurora Bridge" procedure. It's a huge bridge in Seattle that folks have been jumping off pretty much since it was built in the 1930's. Everyone that jumped would get bilateral 12g or 14g Angiocaths. Very few of these ever survived. Now days it's rare that we do bilateral unless it's indicated. The most important thing I learned is it's better to do this on the ground vs. on your stretcher in your rig as the ensuing mess is a nightmare to clean up.
 

VFlutter

Flight Nurse
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Our protocol was to consider needle decompression (uni or bilaterally) before calling it. I think the biggest issue is that a 14G IV cath is not really adequate to treat a hemothorax, even if you place it midaxillary, it's so tiny. It seems like a reasonable step though--needle decompression is probably the most effective ALS trauma intervention that we have and it's probably worth a shot if it's a "fresh" code without an obvious cause of death.

I've only ever personally done bilateral for airway rupture though--it did not work. Finger thoracostomy did, but by then they'd already coded.
Ideally should be using 10g 3.25in but regardless you really shouldn't be decompressing with the hopes of releaving the tension from a hemothorax. Stopcock the catheter and let it be.

Anecdotally, i've had quite a few "saves" from bilateral needle decompressions. Agree it's the one of the few effective interventions we have in traumatic arrest and worth an attempt.
 

Jim37F

Forum Deputy Chief
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Drove the engine to an alarm for the first time, and it was a multi company response for a missing/overdue swimmer SAR in the neighboring stations area, and we were still first on scene!

(Of course Ocean Safety did their thing and found the swimmers within a few min of us getting on scene, so it all worked out nicely)
 

FNGperpetual

Forum Crew Member
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So.. I've been working on the construction site for the last 30 days. Not a single call or pt contact. I miss the ambulance kinda. But that funny..because last time I was on the box I was over it.

I like my AT&T 1st net it's definitely more affordable. I don't really use it at work but to receive text messages with my times. Feel like I'm getting a work phone but I use it as a personal phone that Big brother can monitor.
Does anybody actually use 1st net at their service?
 

NomadicMedic

EMS Edumacator
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So.. I've been working on the construction site for the last 30 days. Not a single call or pt contact. I miss the ambulance kinda. But that funny..because last time I was on the box I was over it.

I like my AT&T 1st net it's definitely more affordable. I don't really use it at work but to receive text messages with my times. Feel like I'm getting a work phone but I use it as a personal phone that Big brother can monitor.
Does anybody actually use 1st net at their service?
My whole department is on first net. I love it. The push to talk is great.
 

Jim37F

Forum Deputy Chief
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^If they don't find you handsome, they should find you handy!

Which means I need to hurry up and wife someone before the looks fade (can def break stuff, building stuff on the other hand... 😂
 
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