Clinical suspicion regarding needle decompression for patients with chest trauma

Alastair Beaven
August 2019

Background: Needle decompression of the chest is indicated for patients in a critical condition with rapid deterioration who have a life-threatening tension pneumothorax. Aim: To reassure UK prehospital care providers that needle decompression of the chest is not commonly required in chest trauma patients, and most can be safely managed without it. Methods: Case studies as part of a major trauma network continuous review process have revealed instances of needle decompression in the absence of tension pneumothorax. Images are presented where needle decompression was attempted in the absence of tension pneumothorax. Context: Expert opinion from our network's multidisciplinary trauma team discuss the occurrence of tension pneumothorax in self-ventilating patients, and the idea that tension pneumothorax is rare in the UK civilian trauma population is acknowledged. Other causes of chest hypoventilation are discussed.

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