Siti Musalama (J210190238)
NEEDLE DECOMPRESSION
Definition
Needle decompression is the first step for immediate treatment of a tension pneumothorax.
Needle thoracostomy is the insertion of a needle into the pleural space to decompress a
tension pneumothorax .
According to trauma guidelines, the needle or venous catheter should be inserted in the
second intercostal space, the mid-clavicular line (2ICS MCL). Injury to vascular structures is
a rare but potentially life-threatening complication of all pleural interventions.
Indication
Trauma patients with tension pneumothorax survive life-threateningly and should be treated
with immediate needle decompression followed by tube thoracostomy.
Contraindications
There are no contraindications because this procedure is only performed because of an
immediate threat to life that supersedes other considerations.
Complications
1. Lung or diaphragm laceration
2. Intercostal neuralgia due to injury to the neurovascular bundle under the ribs
3. Bleeding
4. Infection
5. Perforation of other structures in the chest or abdomen (rare)
Anatomical location
The large gauge needle or angiocatheter is inserted perpendicularly over the superior
aspect of the third rib , and passes over the rib to the bottom of the second intercostal
space at the midclavicular line . The neurovascular bundle is located on the lower edge of
each rib. Therefore, the needle must be placed over the upper edge of the ribs to avoid
damage to the neurovascular bundle .
Equipment
1. needle (over-the-needle catheter is preferable); 8 cm needles are more successful than 5
NEEDLE DECOMPRESSION
Definition
Needle decompression is the first step for immediate treatment of a tension pneumothorax.
Needle thoracostomy is the insertion of a needle into the pleural space to decompress a
tension pneumothorax .
According to trauma guidelines, the needle or venous catheter should be inserted in the
second intercostal space, the mid-clavicular line (2ICS MCL). Injury to vascular structures is
a rare but potentially life-threatening complication of all pleural interventions.
Indication
Trauma patients with tension pneumothorax survive life-threateningly and should be treated
with immediate needle decompression followed by tube thoracostomy.
Contraindications
There are no contraindications because this procedure is only performed because of an
immediate threat to life that supersedes other considerations.
Complications
1. Lung or diaphragm laceration
2. Intercostal neuralgia due to injury to the neurovascular bundle under the ribs
3. Bleeding
4. Infection
5. Perforation of other structures in the chest or abdomen (rare)
Anatomical location
The large gauge needle or angiocatheter is inserted perpendicularly over the superior
aspect of the third rib , and passes over the rib to the bottom of the second intercostal
space at the midclavicular line . The neurovascular bundle is located on the lower edge of
each rib. Therefore, the needle must be placed over the upper edge of the ribs to avoid
damage to the neurovascular bundle .
Equipment
1. needle (over-the-needle catheter is preferable); 8 cm needles are more successful than 5
