Page 144 - Journal of Special Operations Medicine - Summer 2016

Needle Decompression Tension Pneumothorax
Works! Military Medicine 2008

• Several NDC failures seen at autopsy with 5 cm
catheters – then performed 100 virtual autopsies
• Mean chest wall thickness was 4.86 cm
• Predicted success rate for 5 cm catheter - 50%
Video courtesy Dr. Oleksandr Linchevskyy • 8 cm catheter would have reached the pleural space
Medical Director, Patriot Defence in 99% of subjects – other papers confirm
Ukraine 59

NDC – Mayo Clinic Old Army Ranger Saying
February 2016

Lessons Learned aren’t really
lessons learned - unless you
actually learn them.
• Mayo Clinic: 91 NDC procedures on 71 patients
• Pre-March 2011: 5 cm NDC catheters
• Post-March 2011: 8 cm NDC catheters
• Success rates: 5 cm – 41%; 8 cm 83% What length NDC needle is your EMS using?
• No complications with either length 60

JTTS VTC 10 Mar 11 Needle Decompression Site
TBI and Tension Pneumo J Am Coll Surg 2008
• Mounted IED attack
• LOC from closed head trauma
• Lost vital signs prehospital
• CPR on arrival at hospital
• Bilateral NDC done in ER
• Rush of air from left-sided tension pneumo
• Return of VS • 134 consecutive trauma patients at Afghanistan MTF
• Seven needle decompression performed
• Significant DAI at WRAMC • All seven decompressions performed at least 2 cm medial
• TCCC Guidelines changed: Don’t pronounce a to MCL – no major complications noted
casualty with torso trauma until bilateral NDC • Recommended using nipple line as landmark – don’t enter
has been performed the chest medial to this line
• Later recommended 4-5 ICS at AAL as alternate site 63

130 Journal of Special Operations Medicine Volume 16, Edition 2/Summer 2016