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Old 03-30-2009, 11:22   #10
rcm_18d
Quiet Professional
 
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Join Date: Jan 2009
Location: Ocean Springs, MS
Posts: 38
Seal it

I agree that any cx wound is to be sealed, period!

I am merely an 18D(No Doc), and would like all the docs' perspective on when a cx tube should be performed in the field. My current thoughts on this, is when a needle decompression is a recurring event due to blood filling the pleural space and/or massive lung damage. Obviously the duration to further medical care is a huge one, but I understand this criteria. In the case of blood filling the space, I feel that it is a doubled edge sword. I feel it should be performed in conjunction with positive pressure ventilation to maintain some pressure on the lung to somewhat tamponade the bleeding. If it is a patient I will have to sit on for a while, the blood loss needs to be closely monitored, and blood is needed. This is one of the times for a rapid sequence induction, but that has it’s adverse effects as well. A cx tube alone could cause the loss of more blood than life can sustain. Once this sequence is begun the medic will most likely be tied to this patient for obvious reasons. A pleural vac will most likely not be available. Understand I have given chest tubes and I understand how quick and easy they are, but never in the field. Location is 5th ICS MAL. Any thoughts?
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