Combat tip from a medic during desperate circumstances: When doing a Needle Decompression during either combat or lots of noise, it sounds gross to do but lick a portion of your skin above your glove line and then put it over the decompression needle which should allow you to feel air coming out of the needle in any circumstances due to the "cold feeling" of the air hitting your wet skin. No cold feeling means no air coming out. It works.
@@Jimmy_The_Goat High IQ medic...soooo And You are Welcome. Got about a 1,000 tricks after surviving combat. For my next one: I will use Tennis Balls and it is my gold standard favorite trick, nobody can fault, not even the Dr's.
I still remember laying in the hospital with the chest tube for 4 days getting stuck with needles in the stomach every night to prevent blood clots cause you can’t move with that thing. To this day I never got an answer on what cause the pneumothorax
@@mac11daddy6 If you woke up in Germany and had Jolly Rancher's in your pocket, it was my crew or one that I know personally that medivac'ed you. And unfortunately I've been right there with you brother (in the hospital I mean) except mine was a leg with two knees in it located somewhere around my shoulder area which ended up with me being in traction with a strap across my genitals, fun times. ; ) Then why am I smiling about it? Two female nurses had to catheter me after my surgery - payback time! They do say in Medic circles that Pneumo's are Gods way of Saying "Slow your Buttocks Down!" or something like that.
Same trick we used for finding small punctures in bike tires out on windy trails. Except we used to put some water on our face as that's even more sensitive to airflow than your arm.
As a non-medic that does carry a trauma kit and responds to medical calls, I thank you for making this video to demonstrate all the reasons I should not under almost any circumstances attempt this procedure!
The reality is that you will most likely never need to. I know many paramedics in a major city who have never done a needle decompression. If you’re not in combat it’s highly unlikely.
Aaron Phillips I thought by your response “as a non-medic” you were not a paramedic. In the states we generally refer to paramedics as “medics” not just military medics who are often only basic EMTs.
Needles, and especially extra long ones, are never pleasant. But I can promise you this: if your life is really in jeopardy, a long needle will be the least of your concerns.
Reminds me of a guy we had with a lac to the jugular and an IO and all he could was complain about the IO. To be fair if I had to have an intraosseous I wouldn't be concerned with a neck lac either 😂
As a collapsed lung survivor back in high school and looking into becoming an emt I can say that a spontaneous pneumothorax sucks extremely. Getting the air sucked out of you and not knowing what's wrong is terrifying. Stay safe man.
We had to do this in our cls (combat life saver) class in the guard and it was pretty neat to learn. Everyone new to the military is getting cls certified and I believe it's a wonderful skill to have. Thanks for the post man!
@@davew5508 we did iv training on each other and needle d on mannequins plus all the other stuff, and that’s not even the cls course just the all service members course
*don’t stab heart* Okay. *inserts needle.” Did you puncture the heart? *checks notes. Nothing regarding signs heart was punctured* He didn’t say what we should look out for. Jets of shooting blood?
@@Les_Grossman so if there's an off-duty medical professional nearby when something happens, it's not a good thing to have tools they could use to save yours or someone else's life? I know what it's for, and I'm not touching it until I get proper training. But having extra tools is never a bad thing. Also, if I'm the one that needs a decomp, I'm probably not in the state to use it on myself no matter how trained I am 😂
I had two lung collapses and now a lung surgery I applaud your video here honestly I think everyone should at least have the basics of using a compression needle so bravo good sir bravo great videos keep up the awesome work
I’ve treated numerous gunshots, tourniquets, cpr. The tactical medicine training I got was great, but you’re 100% correct. This procedure is not fought enough. I think they are worried about liability with teaching cops invasive procedures with no emt certs
They look disturbingly like cross hairs of a scope in some cases... 🤣 i1.wp.com/www.cutpasteandprint.com/wp-content/uploads/2014/06/regmarks.png?resize=400%2C178&ssl=1
As a National and AZ certified EMT, I can say that unless you're trained, certified as a Paramedic or higher, under medical direction, or you have a medical license and training, don't even try it. You'll penetrate the heart, lung, or great vessels, which will do more harm than good. A sucking chest wound can be a pneumothorax, a hemothorax, or a pneumo/hemo-thorax. Put on occlusive dressings and get the patient to definitive medical care as soon as possible. They're going to need surgery to fix the problem. The proper personnel and the proper surgical theater doesn't exist in the field.
Thank you for being so blunt about it. I'll continue to keep a decompression needle in my IFAK in case I happen to encounter someone who knows how to use it on me, but I'll leave it to the side if I need to treat trauma in the field.
Great info. As a former combat medic, I always thought it was super important to know the signs of tension pneumothorax. There are several, and you're right, tracheal deviation is a late sign. We initially trained with 2nd ICS/mid-clavicle, but started transitioning to mid-axillary anterior 5th ICS. The move to mid ax had less to do with body armor and more to do with mid clavicle being less effective on thicker chested men, and women(breasts). In the beginning (during the invasion), we were using IV needles, but that changed after some lessons learned.
Good to know that about the no-longer-needed one-way valve. Fun fact: instead of using the finger of a glove, I was taught to push the needle through the tip of a lubricated condom. The cut-finger of a glove never sealed anything when I used it. The lubricant helped keep the inside of the condom stuck together and, when unrolled, made an effective one-way valve. And that’s why this faithfully married paramedic kept condoms in his pocket on the band-aid bus.
I have been told the glove tip trick too and I have tested it. You have to put the cut on the side of the finger, so that it is not on the opening of the needle. With that, it is a perfect one-way seal.
This is great info! Now I can tell my wife that I’m carrying condoms for chest decompression. Although she might not believe that someone needs a chest decompression 3 times a week
I had a life-changing experience at the emergency medicine cadaver labs. Everything in your video is spot on as far as how it is taught to the masses. However, there are a few major problems with how these skills are taught that haven't hit the masses yet. - You will never see tracheal deviation as a late or early sign. The books all have that listed because it is visible on an XRAY. It's not a late sign, it's just a sign only seen by radiologists when they get scanned at the hospital. Somehow the idea of it being a late sign occurred, probably out of a misconception.The flexible part of the trachea is not visible to the human eye. -Just to clarify, you are right that the needles are generally too short. But it's not because the needle catheter can't ' get into the thorax' . It's PLENTY long to get inside the thorax. In fact, people frequently biopsy the heart and liver when they insert the needle in. It just isn't long enough to feed the catheter to the superior thorax, (angled towards the collarbone). Most patients only need about 2cm past the ribs to get inside the thorax. -Which leads me to point # 2. EMS academies and schools everywhere are teaching your exact method. Burying the needle all the way in. This is terrible! you can easily stab the heart with less than 2 inches from the midclavicular line. We watched this occur on several of the cadavers. We even stuck our finger in... It' more close than you think. -The correct way to insert the catheter is to grip the needle with two hands. Intentionally find the middle of the rib with the tip of the needle. This depth is highly variable because many people have a ton of adipose tissue. Manually push the needle above/below the rib and proceed 2 cm. Immediately angle the needle towards the collarbone and feed the catheter upwards. You do not want to go much further than 2cm, as there is no reason to do this.
Tim Kyle I was taught taking a 10cc flush, squiring 5cc out and attaching it to the needle. As you insert the needle, you aspirate and you should get a rush of air and that’s how you know you’re in the cavity.
U R big lier TIM. Who R U? How many lives u saves? U will see deviation as a late sign, i saw it. U can easily stab the heart? Really u think this? Do U know where your heart is? Chek this link ( www.wikiskripta.eu/w/Skiagrafie ) and if u can calculate try calculate second and third rib. Voala :) And another lie. Push the needle above or below. This is big diferent, boy. Because below the rib u have veins and nerves bitch its not above/below its only above. Go play tetris sucker.
@@vojtechdonath9742 The only thing I got from your reply is you are angry and immature. Doesn't require needle decompression, but it's something you might want to get checked out anyway.
@@mattterry30 Angry? Yes, because i hate people who lies (as tim kyle). Immature? I dont think so, iam 38 yo and over 10 years i work as a prehospital emergency stuff, so i have probably more experience then tim. If u wana tell someone how u can do the decompression, do it right, thats all.
This and your chest trauma videos were great! I'm a vet who recently decided to start carrying a trauma pack as part of my EDC, and this these were great refreshers of the CLS classes I took so many years ago. Thank you for making them, keep up the great work!!
Just be VERY careful if you decide to use the needle chest decomposition kit, you aren’t protected by the Good Samaritan act if you use it and if done wrong you can be vulnerable to litigation. If you are in a situation where it’s use is necessary and help will not arrive before the subject might die, get video of consent from the patient or their significant other.
Cool video and education. California AEMS just applied this. As a former US ARMY 68W Combat Field Medicine Specialist, we were absolutely allowed to utilize decompression.
Good stuff. Thank you for what you do. I know you may help a lot of people in the medical field, but helping people help themselves or others is a greater gift.
As a nurse, I find this video a valuable training resource. Why, I lament, why Nurses are not cross-trained with Paramedics? As a nurse I need to have these skills, not just hanging IV's and making patient assessments. This has got to change. Thank you very much!
Different skills for different environments, paramedics are prehospitals and nurses are in hospital, if a patient is in hospital, then it would be better to have a chest drain not a needle decompression. For the duration of both courses both paramedic and nursing you only have enough time to learn a definitive amount of work, so the curiculum must be suited to the environement, or each course would have to be substantially longer.
Skills doesn't burden, and it is a life saving skill……a "you don't need it often but when you need it you really fucking need it" kind of tool in your tool box.
Rather have it and not need it than need it and not have it philosophy 👌🏻 I hope to never have to implement this procedure but it’ll be helpful to know
I can almost guarantee that this video will save someones life. Very well presented, especially impressed how you refer to combat situations, and acknowledge that body armour should stay on and to vent from the side as you did. Thank you
This video came up as "Recommended for you" while I was researching ifak/trauma kits. Thank you for doing this! I am of the belief that you should have this equipment in your kit at all times, even if you can't use it, as you are far more likely to run into someone, on the scene, who has the training to use your gear, then you are to stumble upon the gear you need to save a life.
Don Frost I don’t think in the continental US you would ever have a use for this being on your person. Any ambulance that provides ALS and any medivac helicopter can do this procedure.
@@uhavenosushi Yup, I absolutely agree and thank you for your perspective,. But I do not prep for a day at the office. When there is no ALS equipped EMT 15 or 20 minutes away, I'd better be able to take care of me and mine.
Don Frost sure, I suppose it really depends if you are comfortable and have experience with them. I have a decompression needle, but I am a paramedic and have used them in the field several times, and am comfortable doing a needle thoracostomy. The problem is the same with tourniquets and chest seals. Too many people just have them to have them and don’t know how to use them. All three of these devices can cause more problems if used incorrectly, am I rarely come across a layman who knows the correct situation to use them.
@@uhavenosushibut in overcrowded cities ambulances can be delayed or living in a rural area you could be too far from hospital to be saved in time and helicopters could have trouble in fog or anything and not fly. I think it's an excellent idea to have one in the truck or on your person and know how to use it or at the very least have it and maybe somebody else on scene might have proper training to use it. You can't always rely on others,too many unforseen things happen but you can for the most part count on yourself with the proper knowledge, training and will to push on
In combat, we are taught to lay down in line with their head and rest out hands on their chest watching for equal rise and fall while keeping our ear over their mouth listening/feeling for their breathing as well. We use the same techniques you taught here as well (very comforting to know lol). We never treat on the “X” (where the action is) other than our CATs so we have “time” to search and assess the patient. Awesome video
Explain this to me, please. I was watching a video of foreign soldiers in Ukraine, a guy got hit, they waited forever for the MRAP to CasEvac. By that time, the guy was struggling to even gasp for air. Why wouldn't you just ease this guys pain and possibly save his life, on the spot, while you were waiting for a CasEvac?
@@murkypuddle33 obviously we never treated on the X but every situation is different. Also depends on the medical skills of who is present. We have done treatment waiting for Cas but it really depends on the situation all together brother
Thanks for posting always good to refresh on the skill sets - a reminder to those that haven't reviewed this procedure in a while don't forget standard precautions and to prep the site with an alco-swab b4, hate to give my Pt a secondary infection.
I’m taking A&P right now in high school and I think it’s cool I can understand a lot of the medical terms he’s using based on what I learned in the class.
@@austinschmit7616 Yeah. That was two years ago, my freshmen year of high school. I really enjoyed that class but I’m leaning more towards engineering over the medical field. Crazy that you responded though man
Great video! The pucker factor is high doing this the first time but its a rush like no other when the patient gets immediate relief. One of the most important tools in the paramedics tool box in my opinion.
Thanks. I was watching a video of foreign soldiers in Ukraine. They were evacuating a casualty. It took the MRAP so long to get there, and by the time he got there, you could hear the soldier struggling to gasp for air. I knew immediately it was an untreated sucking chest wound, but I was just so stunned that all of those soldiers didn't have some basic understanding of first aid to treat him. It made me want to refresh my knowledge on this. These videos are great. I just wish the people who need this information would come here.
I told a lot of my friends that medical skills like this one is going to be very useful for prepping and after I showed them this video they agreed with me
@@PrepMedic Thank you, it is most appreciated, especially being a volunteer fire fighter, we get no medical training, so I have to pay out of pocket for everything and read up on my own time.
Of the Needles D- performed in North Carolina last year, 2 of 3 the medic stabbed the heart. The needles are not meant to be buried to the hub. The purpose of the needle is to puncture the pleura..! That's it! You can't even breathe threw it until needle is removed. Test it yourself! As you insert attempt to slide catheter in. As soon as catheter inserts without resistance needles stays there then hub the catheter and remove the needle. Catheter can stay in from 10-30 seconds. Trust me. Ask experienced trauma medics/esp military. Also the reason tension pneumo started in first place secondary to puncture is one way valve going in. Great video explaining it by Dr Najeeb!
Ty Shep yes you are right, this was our departments practice prior to making this video and we have since revised it and implemented the SPEAR which allows us to measure the depth more accurately. Not saying it was right but We had the procedure that way due to the difficulty of feeling and hearing the pleural space and the large body size of our patient population. I will be posting a follow up video soon.
One thing I was taught is that when doing it under the arm pit, a easy way to figure out where you should insert the needle is to take the opposite hand of the injured side and to put it across the body. Put their hand into their arm pit without the thumb. And feel for a gap in the ribs around the bottom of their fingers. And a lot of the time its in the correct place. Obviously this is a little faster for combat style self or buddy aid. What’s your thoughts on this method?
Sometimes the arm doesn't come that far over depending on how much equipment is strapped to the front of the chest rig. I would stick with the third insertion point.
I'm current military and we learn this in my combat life savers class but they dont really explain why we do it just how to do it. This helped alot to explain the why.
Im just here to brush up on everything the Navy taught me already. Good video. Almost exactly as I was trained back in '06-07 before a horrible deployment.
Thanks for this video. I'm not trained on this, and don't plan on ever doing it, but I live in the Pacific Northwest, which is a major earthquake zone. As such, having at least a working knowledge of how to do this just might save someone's life in a SHTF, do it or they die for sure because help isn't coming kind of situation.
Thought you should know theres a sony camera video on the medical video playlist. Jave a great week thankyou so much for all the work you do, your patients are so greatful when you arrive
TheChubbyKid hi, i know its been a long time since your coment , the only real reason to use a tourniquet, is if you suffered an amputation and the bleeding is really out of control, thats a no brainer ,but most of the time a really tight bandage around the wound is enough and will make things easier for the medical team (and posibly saving your part of the body wounded) when you get to the hospital. Also you can make a tourniquet almost out of anything.
Andres Hurtado, tourniquets are for arterial bleeding, which is easily identified by spurting, bright red blood. In those cases, a pressure bandage just isn’t going to cut it. It’s also a lot better to put on a tourniquet when not needed than vice versa. Tourniquets can be left on for two hours before permanent damage occurs, plenty of time for professionals to get to you. I will also add that while you can surely use something like a belt as a tourniquet if needed, something like a Combat Application Tourniquet (CAT) can be applied with the use of only one arm/hand, easily allowing it to be self applied if need be.
Good stuff man, glad this information is out there to be found. Active Duty Marine and aspiring EMT here, so glad I can find out this stuff. They only teach us to treat sucking chest wounds with a Chest Seal but this a great follow up!
Excellent video, great explanation. I've also noticed that many services are going down the road of bilateral pleural or lateral decompression for any indication of needle decompression.
Thank you for knowledge. I've been increasingly more interested in being professionally trained in tccc and other medical procedures. I'm more or less the prepper type who wants as much knowledge I can acquire. I've got tourniqit application covered, application of vented chest seals, nasal pharengeal air tube insersion, intermediate trauma intervention, and more.
That's great, how are you now? Do you have any recommendations for me, I live in Latin America and I've experienced many shootings, stabbings, etc. I want to build an IFAK for myself to carry in my bag just in case.
@@mamneo2 You can just go to North American Rescue and buy a complete IFAK. Otherwise buy the Condor tear away pouch, 2 NAR Gen 7 CAT Tourniquets, 2 Hyfin chest seals, 1 Israeli Bandage, 14 gauge ACS needle, Combat Gauze, 2 NAR compressed gauze, Black Sharpie, Chem Lights, Duct tape (flat), 1 roll of medical tape, Super Glue, #10 scaple.... that's what's in my IFAK
Dude, things sure have changed over the years. IED May 25th, 2005 in Iraq....tension hemo-pneumothorax. Long story short, removed body armor and my friend is still alive to this day. Also, the fast way to dart is to use a very simple method for the location...draw a line from the nipple straight up, then draw a line from the nipple perpendicular to the first line. Anywhere in that area is fine. Of course, take into consideration the heart on the left side.
From what I got taught in TCCC in the Marine Corps from a medic was to always aim for that 5th spot he mentioned because of the less risk of puncturing the heart, coming from combat medics who have seem combat etc.
Probably one of the most relieving experiences I’ve ever had. Having air and blood fill up your chest cavity is excruciating but when that needle goes into your lung cavity, it felt like the elephant took its foot off my chest.
Your bringing back memories of my emt and paramedic training I didn’t finish paramedic school as a firefighter I couldn’t make enough money which is sad I’m the only trained fist responder left for 180 co workers and I haven’t been re certified in years my work doesn’t deem it necessary until someone has been hurt there reactive instead of pro active bud !!!!
Hypotension is also an important contributing indication to look for. Attach a flush to the end of the needle so you can see air bubbles indicating you are releasing air and don't need to advance the needle much more causing unnecessary further damage to lung tissue! Just advance that rigid catheter.
I almost died from this exact diagnosis back in the 90's! My lung almost crashed my heart and i had to receive this procedure in the Emergency room. I was fully awake when they drove the chest tube right in! Mine was on the second example on the side that he gave between the 4th clavicle.
@@PrepMedic yes it's good. The title is actually "Three Kings. " With Mark Wahlberg, George Clooney, Ice Cube and some others. Based off of a true story in the first Gulf War. Mark Wahlberg gets shot in the chest and they have to use the needle decompression method. It's pretty good.
The move was good the video what happens is sorta accurate but is shows 2 things that would never happen a three-way stop cock that the pt releases to relieve the pressure in a closed circuit that they made with the stop cock and 2 he got shot in the chest and I am sure for the traumatic value of the scene. I have been a Combat Medic in the Army for over 15 yrs and your videos are really good and informoitive
My ex-husband's was a spontaneous pneumothorax. He wasn't in combat. He was tall and thin and has mitral valve prolapse. And his BP, on a normal day for him, is 90/60.
Me again... In uni we have been taught that, if no equipment is on hand and there is no hope of such equipment arriving within the next few minutes, this can also be done with any sharp knife and any sort of tube, say a pen. Of course, that is highly improvised and a measure of last resort, though I share our profs' view that one should know how to improvise if needed. Without a proper thorax drainage, or at least a Heimlich valve, the lung won't inflate all that much though. Because of the pleural cavity it will collapse due to its own elasticity until sufficient negative pressure is generated to pull it apart again. The main purpose of a pleural puncture is to relieve pressure from the other lung, the heart and great vessels, and the N. vagus. The other lung will provide sufficient oxygenation. By the way, this topic saved my *ss during an anatomy exam.
German law has a way more sensible stand on the matter than US* law. One cannot be punished for any action that was done in good faith to help the patient, merely trained personnel may get into liability issues if they were grossly negligent or did not act to standard. Obviously, if I, or anyone else, had the real equipment on hand, I/they'd do it properly, but choosing between having the patient die because you live in a rural area where the next ambulance is 15 minutes away or at least trying to do a pleural puncture, German law absolutely allows option two. As I mentioned earlier: There is no worse than dead. *I am aware of the pile of paper junk that US law is with all the state jurisdiction and common law.
A tip I was once given by an FTO of mine was after you have decompressed them, take about 12 inches of an IV drip set and cut it off, connect the line to the needle and place the cut end into a bottle of sterile water, then place the water on the stretcher beside the pt, between them and the stretchers hand rail. You can pull the filter section of the trocar and plug the IV set directly into it when you insert it and you can see the air bubble out in the bottle. The water column in the line will resist letting a suction occur and it will filter out any bad things that might make its way thru an open needle hub.
OK overall not a bad video. Been teaching this skill to paramedics since 1986 and yes we have gone through changes in techniques, like using or not using one way valves. One suggestion though, get your hands out of your pockets and off the stethoscope! Place them on the patient's chest. You can feel the side you need to decompress by the bulging intercostal spaces. Nothing else required. Jaws running and sirens blaring no problem. KISS, keep it simple stupid.
Good video. Most new military members, get a brief training on this, but never get any practical experience or probably even know what signs and symptoms. Recently the military has moved to using the second sight on the 3/4 ICS. To many people stabbing people’s hearts… that’s the only update that I’m tracking for military CLS.
Hey man, love the video's, just one notice, the pneumothorax can also occur with SCUBA Divers, when divers ascend too fast, their lungs may rupture, similar to the blunt force. Very uncommon and easily prevented, but it can occur.
Do vented occlusive dressings greatly lower the risk of a tension pneumothorax? I've purchased several Hyfin Vent Chest Seals to bring to the range, and I even keep some at the house in case of having to defend the family from armed intruders. I know lifting one corner non vented chest seals to let air escape from the cavity generally prevents a tension pneumothorax from occurring, but my understanding is that vented chest seals generally eliminate the need to do this. I'm not in law enforcement, nor am I a medic of any type, but I just want to be able to step in if the need should arise. I'm also considering picking up a couple of decompression needles to keep on hand, just in case someone on the scene is trained to used one while being off duty. I would greatly value your opinion on this.
Take needle out after 5 seconds as instructed in the video. Leave the catheter in and remove only by trained medical personnel, preferably at the hospital.
Had a thought for land marks how a skeltelon ? Then u could see the ribs clearly just a thought ikr love ur vids just subbed. emt i and anesthsia tech curr do alot of back country xploring so good to refresh thank U
Best explanation I’ve seen yet my mother had to do this twice in trauma unit and said it’s most hectic situation and time is against you but she already went over it with me so practice would make perfect, can you go over protocol for hypo thoracic and similarities I know procedures change over time do they still have drainage runoff?
i dont understand why the needle should go in the anterior site instead of mid axillary. i also dont understand the need for a 4" catheter. much less risk going in the side although i can see the casualty messing it up after they wake up. i'm not trying to disagree with what you presented. i have very simple med knowledge from the marines.
i appreciate the explanation. i am very weary of performing any type of care as i obviously am not qualified. but i want to know as much as i can just in case the person who needs it is worth the law suit. i will upgrade my needle to the longer and thicker gauge just in case i need poked and all's i have is my ifak. thank you for your service as well! i'm looking forward to starting on a career path similar to yours here shortly.
it would be nearly impossible to hit the heart if you insert mid axillary. that's why i brought it up. there's no risk using the side but substantial risk going anterior. i heard him say the thing about 4 inches but get this. measure your bodies width from chest to back. 3 inches seems to be plenty to pierce the pleura in average people and has been used in combat for a while. the thing about medicine is knowledge is always improving. i just wanted to know more about why and he explained it well. your comment highlights irony as you tell me not to 'do first aid on anything' while you dont understand your own comment.
@@carl-ok9gn Late reply, 2nd Lt or Rt ICS MCL is a safe zone, so is 5th ICS MAL. The 2nd ICS MCL advantage over the 5th is, 1, Ease of access (You don't have to move the arm), 2. Its a safe zone, a perpendicular needle won't hit the heart, 3. It leaves the 5th ICS AAL for the intercostal drain.
Cool, I'm ready to start sticking people should the need arise. First person with so much as light asthma is getting the business.
Well im skrewed
Dude i dont know who you are but id love to shake your hand. Ive been crying laughing at this for the last 10 minutes.
LMFAO
This 10/10.
I'm just gonna find you and stay at least 5 states away
Combat tip from a medic during desperate circumstances:
When doing a Needle Decompression during either combat or lots of noise, it sounds gross to do but lick a portion of your skin above your glove line and then put it over the decompression needle which should allow you to feel air coming out of the needle in any circumstances due to the "cold feeling" of the air hitting your wet skin. No cold feeling means no air coming out.
It works.
high IQ tip, cheers
@@Jimmy_The_Goat High IQ medic...soooo
And You are Welcome. Got about a 1,000 tricks after surviving combat.
For my next one: I will use Tennis Balls and it is my gold standard favorite trick, nobody can fault, not even the Dr's.
I still remember laying in the hospital with the chest tube for 4 days getting stuck with needles in the stomach every night to prevent blood clots cause you can’t move with that thing. To this day I never got an answer on what cause the pneumothorax
@@mac11daddy6 If you woke up in Germany and had Jolly Rancher's in your pocket, it was my crew or one that I know personally that medivac'ed you.
And unfortunately I've been right there with you brother (in the hospital I mean) except mine was a leg with two knees in it located somewhere around my shoulder area which ended up with me being in traction with a strap across my genitals, fun times. ; )
Then why am I smiling about it? Two female nurses had to catheter me after my surgery - payback time!
They do say in Medic circles that Pneumo's are Gods way of Saying "Slow your Buttocks Down!" or something like that.
Same trick we used for finding small punctures in bike tires out on windy trails. Except we used to put some water on our face as that's even more sensitive to airflow than your arm.
As a non-medic that does carry a trauma kit and responds to medical calls, I thank you for making this video to demonstrate all the reasons I should not under almost any circumstances attempt this procedure!
Golden comment.
The reality is that you will most likely never need to. I know many paramedics in a major city who have never done a needle decompression. If you’re not in combat it’s highly unlikely.
@@veiledallegory Aye, there's the rub : I am.
Aaron Phillips I thought by your response “as a non-medic” you were not a paramedic. In the states we generally refer to paramedics as “medics” not just military medics who are often only basic EMTs.
@@veiledallegory non medic but responds to medical calls. Are you a firefighter or a police officer then?
“If you stab the heart, obviously there’s gonna be some problems there.”
Not wrong though haha
People die if they are killed.
People only die if they're not alive tho.
dead people often stop living
My favorite medical related line of the year
Needles, and especially extra long ones, are never pleasant. But I can promise you this: if your life is really in jeopardy, a long needle will be the least of your concerns.
Reminds me of a guy we had with a lac to the jugular and an IO and all he could was complain about the IO.
To be fair if I had to have an intraosseous I wouldn't be concerned with a neck lac either 😂
What in the world is a channel like yours doing here. So weird.
@@mouthbreather280 People lose breath when they see their girls XD
M Alva no the channels just gross.
@@mouthbreather280 beauty is subjective, what you and i find gross others will like, there's niches for most people or products lol
Rule #1: Do Not stab the meaty-beaty with your icky-sticky
Rule #2: Don't talk about stabbing the meaty-beaty with your icky-sticky
👌
As a collapsed lung survivor back in high school and looking into becoming an emt I can say that a spontaneous pneumothorax sucks extremely. Getting the air sucked out of you and not knowing what's wrong is terrifying. Stay safe man.
So what do you do with the plastic cap after taking out the metal needle?? Leave in there forever??...🤔
Marfans?
We had to do this in our cls (combat life saver) class in the guard and it was pretty neat to learn. Everyone new to the military is getting cls certified and I believe it's a wonderful skill to have. Thanks for the post man!
Ninja Gaming When did you serve, I was in 1986 /1990 I went through CLC in 1987. Good program. 82nd Airborne mortar platoon. AATW!
Sad they got rid of a lot of things in CLS (got out 2015) no more IV training no more needle d's basically pack the wound and TQs
@@davew5508 we still do IVs NPAs and obviously not needle ds you’re not going to puncture someone’s thorax in a training situation
@@davew5508 we did iv training on each other and needle d on mannequins plus all the other stuff, and that’s not even the cls course just the all service members course
"If you accidentally stab the patients heart that's gonna be a problem"
*Me, taking notes*
Yoyosten99 well, they wont be dying from the collapsed lung
"hmm yes, I didn't consider this." - Doge
*don’t stab heart*
Okay.
*inserts needle.”
Did you puncture the heart?
*checks notes. Nothing regarding signs heart was punctured*
He didn’t say what we should look out for.
Jets of shooting blood?
Note: don't.... Steb...
"this should only be done by professionals"
Me, with what I thought was a red sharpie in my trauma kit: 👁️👄👁️
@@Les_Grossman so if there's an off-duty medical professional nearby when something happens, it's not a good thing to have tools they could use to save yours or someone else's life? I know what it's for, and I'm not touching it until I get proper training. But having extra tools is never a bad thing. Also, if I'm the one that needs a decomp, I'm probably not in the state to use it on myself no matter how trained I am 😂
@@Les_Grossman it was a joke
@@AntiATF he deleted his comment maybe cuz he realized how dumb he was. I don’t even know what he said :(
🤣🤣🤣
Oh it's a "Sharpie"... and "writes" red
I had two lung collapses and now a lung surgery I applaud your video here honestly I think everyone should at least have the basics of using a compression needle so bravo good sir bravo great videos keep up the awesome work
I’ve treated numerous gunshots, tourniquets, cpr. The tactical medicine training I got was great, but you’re 100% correct. This procedure is not fought enough. I think they are worried about liability with teaching cops invasive procedures with no emt certs
The advantage of going into the 5th intercostal space is it takes you out of the cardiac box. We were taught it during my TCCC course.
Amen
I'm thinking of tatooing 'x's on my chest to pinpoint where the needle should go. That way I could do this to myself if I ever need to.
Not the worst idea in the world.
If you are absolutely sure that you are not going ro gain or lose a large amount of weight/muscle
and one x between your eyes :)
Tattoo instructions too!
They look disturbingly like cross hairs of a scope in some cases... 🤣
i1.wp.com/www.cutpasteandprint.com/wp-content/uploads/2014/06/regmarks.png?resize=400%2C178&ssl=1
As a National and AZ certified EMT, I can say that unless you're trained, certified as a Paramedic or higher, under medical direction, or you have a medical license and training, don't even try it. You'll penetrate the heart, lung, or great vessels, which will do more harm than good. A sucking chest wound can be a pneumothorax, a hemothorax, or a pneumo/hemo-thorax. Put on occlusive dressings and get the patient to definitive medical care as soon as possible. They're going to need surgery to fix the problem. The proper personnel and the proper surgical theater doesn't exist in the field.
Thank you for being so blunt about it. I'll continue to keep a decompression needle in my IFAK in case I happen to encounter someone who knows how to use it on me, but I'll leave it to the side if I need to treat trauma in the field.
Great info. As a former combat medic, I always thought it was super important to know the signs of tension pneumothorax. There are several, and you're right, tracheal deviation is a late sign. We initially trained with 2nd ICS/mid-clavicle, but started transitioning to mid-axillary anterior 5th ICS. The move to mid ax had less to do with body armor and more to do with mid clavicle being less effective on thicker chested men, and women(breasts). In the beginning (during the invasion), we were using IV needles, but that changed after some lessons learned.
Had a bad trauma call the other day. Ended up Decompressing him. Worked really well!
Good to know that about the no-longer-needed one-way valve.
Fun fact: instead of using the finger of a glove, I was taught to push the needle through the tip of a lubricated condom. The cut-finger of a glove never sealed anything when I used it. The lubricant helped keep the inside of the condom stuck together and, when unrolled, made an effective one-way valve.
And that’s why this faithfully married paramedic kept condoms in his pocket on the band-aid bus.
Are you trying to say that I’m an NREMT-AARP?
(Yeah I am. EMT-B 1993, EMT-P 1999, still at it)
I have been told the glove tip trick too and I have tested it. You have to put the cut on the side of the finger, so that it is not on the opening of the needle. With that, it is a perfect one-way seal.
This is great info! Now I can tell my wife that I’m carrying condoms for chest decompression. Although she might not believe that someone needs a chest decompression 3 times a week
Just act smartly and don't geg caught everytime bro😉
Wow, me too! My car first aid kits used to carry a large bore needle (from veterinary supply house) and condoms :)
I had a life-changing experience at the emergency medicine cadaver labs. Everything in your video is spot on as far as how it is taught to the masses. However, there are a few major problems with how these skills are taught that haven't hit the masses yet.
- You will never see tracheal deviation as a late or early sign. The books all have that listed because it is visible on an XRAY. It's not a late sign, it's just a sign only seen by radiologists when they get scanned at the hospital. Somehow the idea of it being a late sign occurred, probably out of a misconception.The flexible part of the trachea is not visible to the human eye.
-Just to clarify, you are right that the needles are generally too short. But it's not because the needle catheter can't ' get into the thorax' . It's PLENTY long to get inside the thorax. In fact, people frequently biopsy the heart and liver when they insert the needle in. It just isn't long enough to feed the catheter to the superior thorax, (angled towards the collarbone). Most patients only need about 2cm past the ribs to get inside the thorax.
-Which leads me to point # 2. EMS academies and schools everywhere are teaching your exact method. Burying the needle all the way in. This is terrible! you can easily stab the heart with less than 2 inches from the midclavicular line. We watched this occur on several of the cadavers. We even stuck our finger in... It' more close than you think.
-The correct way to insert the catheter is to grip the needle with two hands. Intentionally find the middle of the rib with the tip of the needle. This depth is highly variable because many people have a ton of adipose tissue. Manually push the needle above/below the rib and proceed 2 cm. Immediately angle the needle towards the collarbone and feed the catheter upwards. You do not want to go much further than 2cm, as there is no reason to do this.
Tim Kyle I was taught taking a 10cc flush, squiring 5cc out and attaching it to the needle. As you insert the needle, you aspirate and you should get a rush of air and that’s how you know you’re in the cavity.
U R big lier TIM. Who R U? How many lives u saves? U will see deviation as a late sign, i saw it. U can easily stab the heart? Really u think this? Do U know where your heart is? Chek this link ( www.wikiskripta.eu/w/Skiagrafie ) and if u can calculate try calculate second and third rib. Voala :) And another lie. Push the needle above or below. This is big diferent, boy. Because below the rib u have veins and nerves bitch its not above/below its only above. Go play tetris sucker.
@@vojtechdonath9742 The only thing I got from your reply is you are angry and immature. Doesn't require needle decompression, but it's something you might want to get checked out anyway.
@@mattterry30 Angry? Yes, because i hate people who lies (as tim kyle). Immature? I dont think so, iam 38 yo and over 10 years i work as a prehospital emergency stuff, so i have probably more experience then tim. If u wana tell someone how u can do the decompression, do it right, thats all.
Tim isnt lying i see it in surgery alot tonplace ports for lap surgery
This and your chest trauma videos were great! I'm a vet who recently decided to start carrying a trauma pack as part of my EDC, and this these were great refreshers of the CLS classes I took so many years ago. Thank you for making them, keep up the great work!!
Just be VERY careful if you decide to use the needle chest decomposition kit, you aren’t protected by the Good Samaritan act if you use it and if done wrong you can be vulnerable to litigation. If you are in a situation where it’s use is necessary and help will not arrive before the subject might die, get video of consent from the patient or their significant other.
Was trained on this procedure 20 yrs ago at an Army Combat Lifesaver course. Good refresher video thanks.
Ooh did you use it?
No I never had to.
Cool video and education. California AEMS just applied this. As a former US ARMY 68W Combat Field Medicine Specialist, we were absolutely allowed to utilize decompression.
Incroyable.
Good stuff. Thank you for what you do. I know you may help a lot of people in the medical field, but helping people help themselves or others is a greater gift.
As a Marine that had this done to him I've always wanted to know more.
Thank God for Corpsmen.
As a nurse, I find this video a valuable training resource. Why, I lament, why Nurses are not cross-trained with Paramedics? As a nurse I need to have these skills, not just hanging IV's and making patient assessments. This has got to change. Thank you very much!
And medic pay needs to change to be closer to nurse pay also. And everyone of equal licences should definitely be cross trained
liability. that's all it is for management
Different skills for different environments, paramedics are prehospitals and nurses are in hospital, if a patient is in hospital, then it would be better to have a chest drain not a needle decompression. For the duration of both courses both paramedic and nursing you only have enough time to learn a definitive amount of work, so the curiculum must be suited to the environement, or each course would have to be substantially longer.
Don't know why this was recommended for me, but okay then
@@PrepMedic i hope never have to do this tought! lol
Skills doesn't burden, and it is a life saving skill……a "you don't need it often but when you need it you really fucking need it" kind of tool in your tool box.
Rather have it and not need it than need it and not have it philosophy 👌🏻 I hope to never have to implement this procedure but it’ll be helpful to know
You probably get enough vain entertainment.
im scared
I can almost guarantee that this video will save someones life. Very well presented, especially impressed how you refer to combat situations, and acknowledge that body armour should stay on and to vent from the side as you did. Thank you
This video came up as "Recommended for you" while I was researching ifak/trauma kits. Thank you for doing this! I am of the belief that you should have this equipment in your kit at all times, even if you can't use it, as you are far more likely to run into someone, on the scene, who has the training to use your gear, then you are to stumble upon the gear you need to save a life.
Don Frost I don’t think in the continental US you would ever have a use for this being on your person. Any ambulance that provides ALS and any medivac helicopter can do this procedure.
@@uhavenosushi Yup, I absolutely agree and thank you for your perspective,. But I do not prep for a day at the office. When there is no ALS equipped EMT 15 or 20 minutes away, I'd better be able to take care of me and mine.
Don Frost sure, I suppose it really depends if you are comfortable and have experience with them. I have a decompression needle, but I am a paramedic and have used them in the field several times, and am comfortable doing a needle thoracostomy. The problem is the same with tourniquets and chest seals. Too many people just have them to have them and don’t know how to use them. All three of these devices can cause more problems if used incorrectly, am I rarely come across a layman who knows the correct situation to use them.
@@uhavenosushi would you recommend a source that instructs on how to use them properly?
@@uhavenosushibut in overcrowded cities ambulances can be delayed or living in a rural area you could be too far from hospital to be saved in time and helicopters could have trouble in fog or anything and not fly.
I think it's an excellent idea to have one in the truck or on your person and know how to use it or at the very least have it and maybe somebody else on scene might have proper training to use it.
You can't always rely on others,too many unforseen things happen but you can for the most part count on yourself with the proper knowledge, training and will to push on
In combat, we are taught to lay down in line with their head and rest out hands on their chest watching for equal rise and fall while keeping our ear over their mouth listening/feeling for their breathing as well.
We use the same techniques you taught here as well (very comforting to know lol).
We never treat on the “X” (where the action is) other than our CATs so we have “time” to search and assess the patient.
Awesome video
Explain this to me, please. I was watching a video of foreign soldiers in Ukraine, a guy got hit, they waited forever for the MRAP to CasEvac. By that time, the guy was struggling to even gasp for air. Why wouldn't you just ease this guys pain and possibly save his life, on the spot, while you were waiting for a CasEvac?
@@murkypuddle33 obviously we never treated on the X but every situation is different. Also depends on the medical skills of who is present. We have done treatment waiting for Cas but it really depends on the situation all together brother
Thanks for posting always good to refresh on the skill sets - a reminder to those that haven't reviewed this procedure in a while don't forget standard precautions and to prep the site with an alco-swab b4, hate to give my Pt a secondary infection.
I’m taking A&P right now in high school and I think it’s cool I can understand a lot of the medical terms he’s using based on what I learned in the class.
I loved my HS A&P class. I learned a lot and it's still with me 40 years later.
A&P as in anatomy and physiology?
@@austinschmit7616 Yeah. That was two years ago, my freshmen year of high school. I really enjoyed that class but I’m leaning more towards engineering over the medical field. Crazy that you responded though man
@@ethandunn5230 lol I was just scrolling through the comments and saw A&P and it sounded familiar to a class at my HS
Bless you brother I'm a 68W who hasn't done this since AIT and just wanted a refresher keep up the good work.
Great video! The pucker factor is high doing this the first time but its a rush like no other when the patient gets immediate relief. One of the most important tools in the paramedics tool box in my opinion.
As a non-EMT, would it still be feasible to have one in my ifak?
Thanks. I was watching a video of foreign soldiers in Ukraine. They were evacuating a casualty. It took the MRAP so long to get there, and by the time he got there, you could hear the soldier struggling to gasp for air. I knew immediately it was an untreated sucking chest wound, but I was just so stunned that all of those soldiers didn't have some basic understanding of first aid to treat him. It made me want to refresh my knowledge on this. These videos are great. I just wish the people who need this information would come here.
I told a lot of my friends that medical skills like this one is going to be very useful for prepping and after I showed them this video they agreed with me
I have to say, this was the coolest thing I learned in the Army’s 40 hour combat life saving course.
You are very informative and enjoy your show. This brings back my faith in medics.
Can you do a video on Burn Dressings, Burn Gels, and Burn Sheets.
Thank You
@@PrepMedic
Thank you, it is most appreciated, especially being a volunteer fire fighter, we get no medical training, so I have to pay out of pocket for everything and read up on my own time.
KosukiFire it’s easy
Of the Needles D- performed in North Carolina last year, 2 of 3 the medic stabbed the heart.
The needles are not meant to be buried to the hub. The purpose of the needle is to puncture the pleura..! That's it!
You can't even breathe threw it until needle is removed. Test it yourself!
As you insert attempt to slide catheter in. As soon as catheter inserts without resistance needles stays there then hub the catheter and remove the needle.
Catheter can stay in from 10-30 seconds.
Trust me. Ask experienced trauma medics/esp military.
Also the reason tension pneumo started in first place secondary to puncture is one way valve going in.
Great video explaining it by Dr Najeeb!
Ty Shep yes you are right, this was our departments practice prior to making this video and we have since revised it and implemented the SPEAR which allows us to measure the depth more accurately. Not saying it was right but We had the procedure that way due to the difficulty of feeling and hearing the pleural space and the large body size of our patient population. I will be posting a follow up video soon.
I had a lung collapse surgery and these really help me to trust my doctors
My chest started hurting when he pushed that needle in. Ive gone too deep down the UA-cam rabbit hole lol
When a patient can't breathe, that needle insertion is NOTHING. Speaking from experience - 23 years. and counting.
i just did my first one yesterday as a brand new medic! thanks for the tips, sam
One thing I was taught is that when doing it under the arm pit, a easy way to figure out where you should insert the needle is to take the opposite hand of the injured side and to put it across the body. Put their hand into their arm pit without the thumb. And feel for a gap in the ribs around the bottom of their fingers. And a lot of the time its in the correct place. Obviously this is a little faster for combat style self or buddy aid. What’s your thoughts on this method?
I've also heard this method in my training. I actually find the third site to be easiest to find personally.
Sometimes the arm doesn't come that far over depending on how much equipment is strapped to the front of the chest rig. I would stick with the third insertion point.
Great video brought me back to CLS pre deployment
The 5th intercostal is a good site, it’s especially used during a clamshell thoracotomy
I'm current military and we learn this in my combat life savers class but they dont really explain why we do it just how to do it. This helped alot to explain the why.
Im just here to brush up on everything the Navy taught me already. Good video. Almost exactly as I was trained back in '06-07 before a horrible deployment.
Thanks for your service, I am sorry you had to go through that
Former medic here. Great vid and training.
Sweet! I will try this on myself tonight for practice. I figure I've got 2, maybe 3 sticks in me before I need actual help.
Well done. Great basic step by step of the operation and alternative sites. Kudos.
Thanks for this video. I'm not trained on this, and don't plan on ever doing it, but I live in the Pacific Northwest, which is a major earthquake zone. As such, having at least a working knowledge of how to do this just might save someone's life in a SHTF, do it or they die for sure because help isn't coming kind of situation.
Thought you should know theres a sony camera video on the medical video playlist. Jave a great week thankyou so much for all the work you do, your patients are so greatful when you arrive
It bugs me that these tactical websites include these but not a tourniquet in a trauma kit.
It’s to look sexy and sell first aid kits to wanna be bad assess
TheChubbyKid hi, i know its been a long time since your coment , the only real reason to use a tourniquet, is if you suffered an amputation and the bleeding is really out of control, thats a no brainer ,but most of the time a really tight bandage around the wound is enough and will make things easier for the medical team (and posibly saving your part of the body wounded) when you get to the hospital. Also you can make a tourniquet almost out of anything.
I assume said tactical websites are encouraging people to carry one trauma kit and separately multiple tourniquets in multiple locations.
Andres Hurtado, tourniquets are for arterial bleeding, which is easily identified by spurting, bright red blood. In those cases, a pressure bandage just isn’t going to cut it. It’s also a lot better to put on a tourniquet when not needed than vice versa. Tourniquets can be left on for two hours before permanent damage occurs, plenty of time for professionals to get to you. I will also add that while you can surely use something like a belt as a tourniquet if needed, something like a Combat Application Tourniquet (CAT) can be applied with the use of only one arm/hand, easily allowing it to be self applied if need be.
@@actionjackson9393, they can be left in for 6 hours max actually. Tho the longest I've heard without nerve damage is 8 hours.
Homie shooting this video in a supply closet!!! Big respect my dude!!! Get it how you live!!!
I've just started watching you, I'm in ireland and I have just subbed. You are going to go far, keep up the great videos.
I love your content and the way to clearing and easily explain things.
Thanks for the great video! Keep up the great work!
Hi, I'm a firearm operator, i'm following you from Turkey. I found your video really helpful. I appreciate you sharing this information. :)
*W A R N I N G:* This video may cause..... Manual breathing.
@@CitizenSnips69 and now your tongue is sitting awkwardly in yoir mouth...
The paaaiiinnnnn
@@marshadowiethis is why youtube needs a sad react button
LoL.
Thank you for this video! I always wondered how this procedure worked.
Good stuff man, glad this information is out there to be found. Active Duty Marine and aspiring EMT here, so glad I can find out this stuff. They only teach us to treat sucking chest wounds with a Chest Seal but this a great follow up!
Current EMT and Medic student. So far more than half of the stuff we’ve covered in class is on UA-cam, what a time to be alive hope you’re doing well
@@BACONHAWK10-22 Thanks I will be sure to brush up, try to soak up like a sponge. Thanks I'm doing okay, hope you are too
Excellent video, great explanation. I've also noticed that many services are going down the road of bilateral pleural or lateral decompression for any indication of needle decompression.
I cant find my third rib to save my life
It is right before your 4th. :)
I found my 3rd leg.
@@jjlatinopedia well when ur 3 leg is as small as urs is it may take u a while but im glade u finally found it lol
JT 1200 I found it now that you removed your lips from it. Same time tomorrow?
OrganicChemistry2 when the fuck did this turn into the garandthumb comment section???
Thank you for knowledge. I've been increasingly more interested in being professionally trained in tccc and other medical procedures. I'm more or less the prepper type who wants as much knowledge I can acquire. I've got tourniqit application covered, application of vented chest seals, nasal pharengeal air tube insersion, intermediate trauma intervention, and more.
That's great, how are you now?
Do you have any recommendations for me, I live in Latin America and I've experienced many shootings, stabbings, etc. I want to build an IFAK for myself to carry in my bag just in case.
@@mamneo2 You can just go to North American Rescue and buy a complete IFAK. Otherwise buy the Condor tear away pouch, 2 NAR Gen 7 CAT Tourniquets, 2 Hyfin chest seals, 1 Israeli Bandage, 14 gauge ACS needle, Combat Gauze, 2 NAR compressed gauze, Black Sharpie, Chem Lights, Duct tape (flat), 1 roll of medical tape, Super Glue, #10 scaple.... that's what's in my IFAK
Dude, things sure have changed over the years. IED May 25th, 2005 in Iraq....tension hemo-pneumothorax. Long story short, removed body armor and my friend is still alive to this day. Also, the fast way to dart is to use a very simple method for the location...draw a line from the nipple straight up, then draw a line from the nipple perpendicular to the first line. Anywhere in that area is fine. Of course, take into consideration the heart on the left side.
This was a helpful refresh. I’ve been out of the army for 12 years, but writing a book and wanted to get it right. 😂 Thank you!
From what I got taught in TCCC in the Marine Corps from a medic was to always aim for that 5th spot he mentioned because of the less risk of puncturing the heart, coming from combat medics who have seem combat etc.
The best video about needle decompression.
Probably one of the most relieving experiences I’ve ever had. Having air and blood fill up your chest cavity is excruciating but when that needle goes into your lung cavity, it felt like the elephant took its foot off my chest.
Your bringing back memories of my emt and paramedic training I didn’t finish paramedic school as a firefighter I couldn’t make enough money which is sad I’m the only trained fist responder left for 180 co workers and I haven’t been re certified in years my work doesn’t deem it necessary until someone has been hurt there reactive instead of pro active bud !!!!
Hypotension is also an important contributing indication to look for.
Attach a flush to the end of the needle so you can see air bubbles indicating you are releasing air and don't need to advance the needle much more causing unnecessary further damage to lung tissue! Just advance that rigid catheter.
Excellent tutorial (for general information). Solid video.
I'm taking A&P and med term and I actually understood the medical terminology he used. I'm proud of myself 😂😂
Good job! No to be redundant but...it makes MORE sense when things make sense, i.e. the proper terms add to accuracy and understanding for sure!
I almost died from this exact diagnosis back in the 90's! My lung almost crashed my heart and i had to receive this procedure in the Emergency room. I was fully awake when they drove the chest tube right in! Mine was on the second example on the side that he gave between the 4th clavicle.
This was done in the movie "The three kings. "
@@PrepMedic yes it's good. The title is actually "Three Kings. " With Mark Wahlberg, George Clooney, Ice Cube and some others. Based off of a true story in the first Gulf War. Mark Wahlberg gets shot in the chest and they have to use the needle decompression method. It's pretty good.
The move was good the video what happens is sorta accurate but is shows 2 things that would never happen a three-way stop cock that the pt releases to relieve the pressure in a closed circuit that they made with the stop cock and 2 he got shot in the chest and I am sure for the traumatic value of the scene. I have been a Combat Medic in the Army for over 15 yrs and your videos are really good and informoitive
@@notyoursmine1 wow the things you must of seen. Thank you for your service.
My ex-husband's was a spontaneous pneumothorax. He wasn't in combat. He was tall and thin and has mitral valve prolapse. And his BP, on a normal day for him, is 90/60.
Hey, I found another Iowan. It's cool to see you!
I feel more confident now. Thank you.
Me again... In uni we have been taught that, if no equipment is on hand and there is no hope of such equipment arriving within the next few minutes, this can also be done with any sharp knife and any sort of tube, say a pen. Of course, that is highly improvised and a measure of last resort, though I share our profs' view that one should know how to improvise if needed.
Without a proper thorax drainage, or at least a Heimlich valve, the lung won't inflate all that much though. Because of the pleural cavity it will collapse due to its own elasticity until sufficient negative pressure is generated to pull it apart again. The main purpose of a pleural puncture is to relieve pressure from the other lung, the heart and great vessels, and the N. vagus. The other lung will provide sufficient oxygenation.
By the way, this topic saved my *ss during an anatomy exam.
German law has a way more sensible stand on the matter than US* law. One cannot be punished for any action that was done in good faith to help the patient, merely trained personnel may get into liability issues if they were grossly negligent or did not act to standard.
Obviously, if I, or anyone else, had the real equipment on hand, I/they'd do it properly, but choosing between having the patient die because you live in a rural area where the next ambulance is 15 minutes away or at least trying to do a pleural puncture, German law absolutely allows option two. As I mentioned earlier: There is no worse than dead.
*I am aware of the pile of paper junk that US law is with all the state jurisdiction and common law.
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Jesus Christ no
A tip I was once given by an FTO of mine was after you have decompressed them, take about 12 inches of an IV drip set and cut it off, connect the line to the needle and place the cut end into a bottle of sterile water, then place the water on the stretcher beside the pt, between them and the stretchers hand rail. You can pull the filter section of the trocar and plug the IV set directly into it when you insert it and you can see the air bubble out in the bottle. The water column in the line will resist letting a suction occur and it will filter out any bad things that might make its way thru an open needle hub.
I was waiting for the medic to stick that needle into someone's chest .. but it's fine i have learnd something today.
Side note...i was taught 2 ALWAYS stick needle as close 2 above the rib 2 avoid nething vascular or nerves which ride under the ribs.
So the 4th or 5th AAL is our 2nd choice now you use mid axillary for chest tubes.
PrepMedic sorry I meant mid axillary thanks you but no we don’t do anterior chest tubes we can do them on the MAL or AAL
As a former Hospital Corpsman this is great information!
OK overall not a bad video. Been teaching this skill to paramedics since 1986 and yes we have gone through changes in techniques, like using or not using one way valves. One suggestion though, get your hands out of your pockets and off the stethoscope! Place them on the patient's chest. You can feel the side you need to decompress by the bulging intercostal spaces. Nothing else required. Jaws running and sirens blaring no problem. KISS, keep it simple stupid.
I'm in the army reserves just had this training at my last drill thanks for refreshment
Signs of a TPT. You mentioned tracheal deviation but not JVD.
Good video. Most new military members, get a brief training on this, but never get any practical experience or probably even know what signs and symptoms. Recently the military has moved to using the second sight on the 3/4 ICS. To many people stabbing people’s hearts… that’s the only update that I’m tracking for military CLS.
how long does the decompression niddle can stay in the bag without being used.. How long does it last if not used?
Hey man, love the video's, just one notice, the pneumothorax can also occur with SCUBA Divers, when divers ascend too fast, their lungs may rupture, similar to the blunt force. Very uncommon and easily prevented, but it can occur.
Do vented occlusive dressings greatly lower the risk of a tension pneumothorax? I've purchased several Hyfin Vent Chest Seals to bring to the range, and I even keep some at the house in case of having to defend the family from armed intruders. I know lifting one corner non vented chest seals to let air escape from the cavity generally prevents a tension pneumothorax from occurring, but my understanding is that vented chest seals generally eliminate the need to do this. I'm not in law enforcement, nor am I a medic of any type, but I just want to be able to step in if the need should arise. I'm also considering picking up a couple of decompression needles to keep on hand, just in case someone on the scene is trained to used one while being off duty. I would greatly value your opinion on this.
Thanks for your reply. Makes perfect sense to me.
I'd love to change the world... That song is part of the ending music, vary interesting, great video by the way👍.
Thanks a lot. Question though; for how long do u leave the needle in place in the chest
Take needle out after 5 seconds as instructed in the video. Leave the catheter in and remove only by trained medical personnel, preferably at the hospital.
4:30 Or like they told us about knives in Infantry school- "Stab between the second and third rib and twist!" minus the knife and the twist.
U should have a store, I would buy from it👌
Did my first one last year it was crazy. But i still refreshing every once in a while.
Had a thought for land marks how a skeltelon ? Then u could see the ribs clearly just a thought ikr love ur vids just subbed. emt i and anesthsia tech curr do alot of back country xploring so good to refresh thank U
Best explanation I’ve seen yet my mother had to do this twice in trauma unit and said it’s most hectic situation and time is against you but she already went over it with me so practice would make perfect, can you go over protocol for hypo thoracic and similarities I know procedures change over time do they still have drainage runoff?
Why did my squeamish ass click on this video?
i dont understand why the needle should go in the anterior site instead of mid axillary. i also dont understand the need for a 4" catheter. much less risk going in the side although i can see the casualty messing it up after they wake up. i'm not trying to disagree with what you presented. i have very simple med knowledge from the marines.
i appreciate the explanation. i am very weary of performing any type of care as i obviously am not qualified. but i want to know as much as i can just in case the person who needs it is worth the law suit. i will upgrade my needle to the longer and thicker gauge just in case i need poked and all's i have is my ifak. thank you for your service as well! i'm looking forward to starting on a career path similar to yours here shortly.
it would be nearly impossible to hit the heart if you insert mid axillary. that's why i brought it up. there's no risk using the side but substantial risk going anterior. i heard him say the thing about 4 inches but get this. measure your bodies width from chest to back. 3 inches seems to be plenty to pierce the pleura in average people and has been used in combat for a while. the thing about medicine is knowledge is always improving. i just wanted to know more about why and he explained it well. your comment highlights irony as you tell me not to 'do first aid on anything' while you dont understand your own comment.
@@carl-ok9gn Late reply, 2nd Lt or Rt ICS MCL is a safe zone, so is 5th ICS MAL. The 2nd ICS MCL advantage over the 5th is, 1, Ease of access (You don't have to move the arm), 2. Its a safe zone, a perpendicular needle won't hit the heart, 3. It leaves the 5th ICS AAL for the intercostal drain.