Page 89 - Journal of Special Operations Medicine - Spring 2016

of the procedure, and the needle hub is the proper /media/NAR/product-info-sheets/EP-ARS.pdf. Accessed 21 June
grasping location. In this manner, the catheter will be 2015.
carried through the chest along with the needle itself. 11. Beckett A, Savage E, Pannell D, et al. Needle decompression
for tension pneumothorax in tactical combat casualty care:
Frequently, we and other instructors have observed the do catheters placed in the midaxillary line kink more often
catheter being advanced off the rigid needle into the than those in the midclavicular line? J Trauma. 2011;71:
skin and muscle of the chest wall before the catheter S408–S412.
12
has entered the pleural space. However, we have also 12. Harcke HT, Mabry RL, Mazuchowski EL. Needle thoracente-
seen users cover the end of the needle with a thumb sis decompression: observations from postmortem computed
tomography and autopsy. J Spec Oper Med. 2013;13:53–58.
or finger, occluding the exit for any air that may be
detected upon pleural cavity entrance.
CPT Studer, MC, FS, USA is with the Multinational Force
Training for this procedure must not overlook these & Observers, US Army Task Force Sinai, El Gora, Egypt.
small mistakes in technique that can, and have, led to E-mail: nicholas.m.studer2.mil@mail.mil.
device failure in actual combat casualties. We recom-
mend their inclusion in training guidelines and skill CPT Horn, MC, USA is with the Walter Reed National
Military Medical Center, Naval Support Annex, Bethesda,
sheets throughout the Armed Forces.
Maryland.
Disclosures Keywords: needle thoracostomy; tension pneumothorax;
Combat Medic; medical training
The authors have nothing to disclose.

Disclaimers
The views expressed herein are those of the authors and
do not reflect the official policy or position of the US
Army Medical Department, the US Army Office of the
Surgeon General, the Department of the Army and De-
partment of Defense, or the US Government.

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