Emergency needle thoracostomy converting tension to simple pneumothorax.
Indications
- • Tension pneumothorax — respiratory distress + hypotension + distended neck veins + tracheal deviation + absent breath sounds
Contraindications
- ⚠ None if clinically indicated (life-saving)
Equipment
- • 14–16 G angiocatheter (≥ 5 cm)
- • Antiseptic swab
Positioning
- • As appropriate for the procedure and patient comfort.
Consent
- • Explain indication, benefits, alternatives
- • Explain risks & complications
- • Obtain written/verbal consent as per SOP
- • Document consent
Universal precautions
- • Hand hygiene
- • PPE — gloves, mask, eye protection
- • Aseptic technique
- • Sharps safety
- • Verify patient identity & site
Step-by-step (0/4)
Tap to complete
Clinical diagnosis — do NOT wait for CXR.
Immediate complications
- ⚠ Failure (short catheter)
- ⚠ Cardiac/vessel injury
- ⚠ Hemothorax
Recognition
- • No hiss
- • Persistent tension
Initial management
- • Longer needle; alt site; chest tube
Prevention
- • Correct site & length
Post-procedure observation
- • Vitals q15min × 1h then hourly
Monitoring
- • Site inspection
- • Symptom review
Documentation
- • Procedure note
- • Consent
- • Findings
Patient instructions
- • Report pain, bleeding, fever, worsening symptoms
Educational bedside guide. Perform only under supervision until competent. Follow local SOPs and consent policy.
