Trauma Assessment - Multiple Injuries (Part 1) 

indeed. this video is really nice

Incorrect. this is an emergency needle aspiration of a tension pneumothorax. "Needle thoracocentesis" was described as taught by American, Australian and European guidelines.

thanks for your response. You should check out ATLS`s procedure description at it's latest edition. It says, ipsis literis: Needle Decompression "For adults (especially with thicker subcutaneous tissue), use the fourth or fifth intercostal space anterior to the midaxillary line"@@amitpatel86

Hey i just watch this video and i agree with you

But i have to say that this video was being publicated 10 years ago so during that times what he did is based on the procedure.

@@paska_lia4340 EXTRACTLY

Hahaha

It's continued in part 2 from where this part leaves off. RU-vid is showing an inaccurate duration, possibly left over in the original video file from when the original recording was split into 2 parts.

Both terms are interchangeable. thoraco (thorax) centesis (puncture for aspiration). refer to ru-vid.com/video/%D0%B2%D0%B8%D0%B4%D0%B5%D0%BE-sJ5eCDEcyKI.html.

Hi Harish, 1. Emergency needle thoracocentesis is only a temporary procedure. After it has relieved the pressure you need to place a definitive drain (if indeed there was a tension pnuemothorax). This requires insertion of a chest drain, which is attached to an underwater seal as are all chest drains. See www.oxfordmedicaleducation.com/clinical-skills/procedures/intercostal-drain/ for details. 2. A tension pneumothorax is any pneumothorax where a pathological one-way valve leads to positive pleural pressure and subsequent venous compression with haemodynamic compromise. This MAY lead to tracheal deviation but you can have significant tension pneumothorax without tracheal deviation. Having said that, in trauma patients with tracheal deviation, respiratory and haemodynamic compromise, tension pneumothorax should always be top of your list. Hope this helps.

Thank you so much. If a patient is having pneumothroax with hyper resonant sounds with no obvious breathlessness & stable vitals with high hyperresonant sounds .Can we directly go for ICD than needle decompression ?

Absolutely. If a pneumothorax is suspected clinically but there is no immediate compromise then no need to do needle decompression; you have some time. Get a CXR to confirm pneumothorax, followed by formal ICD. For usual pneumothorax management see guidelines on www.oxfordmedicaleducation.com/emergency-medicine/pneumothorax/

What was done was needle decompression, just a temporary management of tension pneumothorax. The definitive one which is a tube thoracostomy, should be connected to an under water seal

This is exam practice, this simulates the exam setting quite well

“Could you prepare the chest drain kit for me”

Anestesiologist

@@yurineri2227 for an airway? An ED doc can intubate no problem. A paramedic can intubate no problem. Seems silly to call for a specialist.

Wtf

wtf...