Needle Decompression: A Life-Saving Procedure

Tension pneumothorax is a medical emergency requiring immediate intervention. Needle decompression is a quick and temporary measure to relieve pressure before definitive chest tube placement.

Indications

? Severe respiratory distress

? Absent breath sounds on one side

? Tracheal deviation (late sign)

? Hypotension & JVD (signs of obstructive shock)

Procedure Steps

1?? Assess – Confirm signs of tension pneumothorax.

2?? Oxygen – Provide high-flow O?, assist ventilation.

3?? Identify the Site –

? Adults: 4th/5th ICS, anterior to midaxillary line

? Pediatrics: 2nd ICS, midclavicular line

4?? Prep & Anesthetize – Clean the site, anesthetize if possible.

5?? Insert Needle – Use a 3-inch (8 cm) over-the-needle catheter with a 10 cc syringe. Insert just above the rib, aspirating for air.

6?? Puncture Pleura – Confirm air release.

7?? Advance Catheter – Remove the needle, leaving the catheter in place.

8?? Secure & Monitor – Stabilize the catheter and prepare for chest tube insertion.

Key Points

? Use large-bore (14-16G) catheter for adults.

? Needle decompression is temporary—always follow with chest tube placement.

? If no improvement, consider malposition or blockage and reassess.

This simple but critical procedure can prevent cardiac arrest—act fast! ??