Pleural Decompression

Section 9 - Procedure Guidelines

INDICATIONS:

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.