Tension PTX.Download the full "TCCC"
TACTICAL COMBAT CASUALTY CARE HANDBOOK here
Assume any progressive, severe respiratory distress on the battlefield resulting from unilateral penetrating chest trauma represents a tension PTX.
Do not rely on such typical signs as breath sounds, tracheal shift, and hyper-resonance on percussion for diagnosis in this setting,
because these signs may not always be present. Even if these signs are present, they may be difficult to detect on the battlefield.
Treattension PTXs in the tactical field care phase via decompression (watch a video) with a 14-gauge, 3.25-inch-long needle catheter.
Another Video More of a civilian bent
A casualty with penetrating chest trauma will generally have some degree of hemothorax or PTX as a result of his primary wound.
The additional trauma caused by a needle thoracostomy will not worsen his condition should he not have a tension PTX.
Decompress the casualty with the needle and catheter, removing the needle and leaving the catheter buried to the hub.
The medic must monitor this casualty after the procedure to ensure the catheter has not clotted or dislodged and that respiratory symptoms have not returned.
If respiratory symptoms have returned or the catheter is clotted or dislodged, flush the catheter or perform a second needle thoracostomy adjacent to the first.
Chest tubes are not recommended during this phase of care, as they are not needed for initial treatment of a tension PTX, are more technically difficult and time-consuming to perform, and are more likely to result in additional tissue damage and subsequent infection.
TACTICAL COMBAT CASUALTY CARE HANDBOOK here
Assume any progressive, severe respiratory distress on the battlefield resulting from unilateral penetrating chest trauma represents a tension PTX.
Do not rely on such typical signs as breath sounds, tracheal shift, and hyper-resonance on percussion for diagnosis in this setting,
because these signs may not always be present. Even if these signs are present, they may be difficult to detect on the battlefield.
Treattension PTXs in the tactical field care phase via decompression (watch a video) with a 14-gauge, 3.25-inch-long needle catheter.
Another Video More of a civilian bent
A casualty with penetrating chest trauma will generally have some degree of hemothorax or PTX as a result of his primary wound.
The additional trauma caused by a needle thoracostomy will not worsen his condition should he not have a tension PTX.
Decompress the casualty with the needle and catheter, removing the needle and leaving the catheter buried to the hub.
The medic must monitor this casualty after the procedure to ensure the catheter has not clotted or dislodged and that respiratory symptoms have not returned.
If respiratory symptoms have returned or the catheter is clotted or dislodged, flush the catheter or perform a second needle thoracostomy adjacent to the first.
Chest tubes are not recommended during this phase of care, as they are not needed for initial treatment of a tension PTX, are more technically difficult and time-consuming to perform, and are more likely to result in additional tissue damage and subsequent infection.
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