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Old 03-04-2005, 02:52   #11
Thursday
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Join Date: Feb 2005
Location: Illinois
Posts: 5
Quote:
Originally Posted by swatsurgeon
Saca is correct...let me add one thing....tracheal deviation, low blood pressure are 'later' signs of tension PTX.
This is definately correct. We just finished up learning all flavors of PTX ( hemo, tension, closed, open ) in class.

Tracheal deviation is an extremely late sign that will indicate that the effected lung has shifted at least 6 to 8 inches. If a medic simply waits to diagnose a TPTX by tracheal deviation, that pt. will most likely die if they are not decompressed immediately. Even JVD is a late sign, indicating a failing right side of the chest, producing excess fluid backup in the Vena Cava.

I do have a question about chest tubes though, seeing as though we dont do them in the civilian EMS field. I know that a needle decompression is in the 2nd intercostal, where would a chest tube be inserted? Is it more medial, in the 2nd?
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