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Template:Needle aspiration of pneumothorax
From WikEM
Needle Aspiration of Pneumothorax
- Use thoracentesis or "pig-tail" kit, if available
- Place in 2nd IC space in midclavicular line or 4th/5th IC space in anterior axillary line
- Withdraw air with syringe until no more can be aspirated
- Assume a persistent air leak (failure) if no resistance after 4 liters of air has been aspirated AND the lung has not expanded
- Once no further air can be aspirated:
- Option 1
- Place closed stopcock and secure catheter to the chest wall
- Obtain CXR four hours later
- If adequate lung expansion has occurred, remove catheter
- Following another two hours of observation, obtain another CXR
- If the lung remains expanded, may discharge patient
- Option 2
- Leave catheter in place
- Attached a Heimlich (one-way) valve
- May discharge with follow-up within two days
- Option 1
