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Needle Thoracostomy (Decompression)

In suspected tension pneumothorax, needle thoracostomy is a life-saving temporising procedure.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Acil Servis department. Book Appointment →

What is Needle Thoracostomy (Decompression)?

Needle thoracostomy (needle decompression) is an emergency procedure that rapidly reduces pleural air pressure in patients with diagnosed tension pneumothorax.

Classically a large-bore needle (14G-16G) is inserted in the 2nd intercostal space at the midclavicular line (or the 5th ICS in the midaxillary line). It is a temporary solution and tube thoracostomy must follow.

The procedure can be performed in the field by paramedics and emergency physicians. Incorrect technique may injure the lung, vessels or nerves.

Symptoms

Unilateral loss of breath sounds
Tracheal deviation (to the contralateral side)
Hypotension and tachycardia
Distended neck veins
Hypoxia and cyanosis
Reduced chest wall movement on one side

Risk Factors

Penetrating chest trauma
Blunt chest trauma and rib fractures
Complications of positive-pressure ventilation
Barotrauma
History of thoracic surgery
Tuberculosis and bullous lung disease

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Call emergency services for post-trauma dyspnoea and hypotension
  • Treatment can be initiated in the transport ambulance
  • Emergency department evaluation is required after the procedure
  • Confirmation chest X-ray or ultrasound should be obtained

Treatment Methods

01
Sterile field preparation and equipment check
02
Identify the anatomical landmark (2nd ICS midclavicular)
03
Vertical insertion of a large-bore needle with audible air release
04
Following pressure relief, prepare for tube thoracostomy
05
Patient monitoring and oxygen therapy
06
Definitive chest tube placement

Which Department to Visit?

You can visit our Acil Servis department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.