Pleural Decompression

Section 9 - Procedure Guidelines

9.26 PLEURAL DECOMPRESSION

INDICATIONS:

• Chest decompression for relief of tension pneumothorax.

EQUIPMENT:

• 14 gauge 2 - 2.5 inch catheter over the needle.
• Sterile glove finger.
• Thread the #14 gauge catheter through the end of the glove finger from the inside.
• Tape.
• Sterile gauze pads.
• Antiseptic swabs.
• Occlusive dressing.

PROCEDURE:

• Locate decompression site.
  • Identify the 2nd intercostal space in the mid-clavicular line on the same side as the pneumothorax. OR
  • Identify the 5th intercostal space in the mid-axillary line on the same side as the pneumothorax.
• Prepare the site with an antiseptic swab:
• Firmly introduce catheter immediately above the distal rib of the site selected with a glove finger placed over the needle and catheter to serve as a flutter valve.
• Insert the catheter through the parietal pleura until air exits. It should exit under pressure.
• Advance catheter and remove needle.
• Secure the catheter taking care not to allow it to kink.
• Reassess lung sounds and patient condition.
• Dress area with Occlusive dressing then cover with sterile gauze pad.
• Flutter valve must be outside dressing and unobstructed.
• Assess breath sounds and respiratory status.