Needle Chest Decompression

• Step 1

  1. PPE (Latex gloves, hand hygiene)
  2. High-flow O2 via face mask or non-rebreather
  3. Face shield
• Step 2

  1. Remove chest seals/occlusive dressings that have been obstructed by blood -> Creates opening required to alleviate pressure
• Step 3 - Identifying appropriate site for decompression

  1. Second intercostal space (2nd ICS)
  2. Midclavicular line (or more lateral \ further from the sternum)

  
• Step 5 - Cleaning site

  1. Use iodine solution
  2. Wiping technique by spiralling outwards from insertion site
• Step 6

  1. Insert the needle at 90 degrees to the skin
  2. If rib is struck by needle, run over the top of the rib to avoid neurovascular bundle
  3. Correct placement may be associated with an audible rush (whooshing) of air from the needle.
• Step 7

  Secure the device using the proprietary stabiliser or with tape as appropriate.