Cook Pneumothorax Kit

[ender18d]

I've been asking all of the experienced field medics about this device, and so far most people haven't used it or seen it used.... Does anyone carry this in their aid-bag?

I got the chance to administer a Cook Catheter in Tampa, and had a great long talk about this device with a Doc at Ireland Army Hospital at FT Knox during my SOC-T...

The kit is light, self contained, and small... a negligable space or weight concern. Basically a nice big flexible cath with (if I remember correctly) some additional fenstrations. Inserts 2nd ICS MCL just like a standard decompression, but has built-in Heimlich and can be connected to standard pleurevac. In Tampa we used this device for definitive care on a roughly 30% spontaneous left-side pneumo, and X-rays demstrated full efficacy of treatment. The docs at both hospitals said that it is very common that this device can eliminate the need for a more invasive and painful chest-tube. This seems ideal to me for field use as an alternative to many chest-tubes, particularly for the borderline cases, such as a GSW to chest that must go on a bird, but may not display S/S of pneumo. I'd sure hate to stick a field-finger in that guy's pleural space, but this needle might be a good compromise.

Anyone have any experience or thoughts on this type of device?

http://www.armstrongmedical.com/ami/...=71&itemid=721

[greg c]

I've never used the kit, but the premise is similar to most other pleural space catheter kits.

I'd be careful preemptively sticking one in a GSW that has no Sx- if he's not got a pneumothorax, you might stick that needle into the lung. You'll get a nice air return, and then you'll confidently stick that catheter right into lung tissue. Oops.

[ender18d]

Thank you-- that brings up another question I had...

I was trained in the schoolhouse that *anyone* with a penetrating chest wound should get a chest tube prior to air evac, even without S/S... this always seemed like *Very* aggressive treatment to me (and is one of the reasons I was particularly enthused about this cath, as a compromise for the air-evac patient)... since the chest tube is an austere environment is very far from ideal, albeit sometimes a neccessary lifesaving procedure. What guidelines are appropriate as to when either chest-tube or the cook cath should be used for an air-evac patient? I'm quite comfortable as far as treatment thresholds for ground patients, but how much more aggressive should I be if he's potentially going to be exposed to pressure changes that could gravely excacerbate a condition that's barely detectable on the ground. I can imagine how the chest tube represents less danger to a (possibly) inflated lung than the cath needle...

Any thoughts?

[52bravo]

IDF has do som thing aboute chest tube air-evac, one doc from talled my that you use to must time on it. time s life so needel them.
Mattox say the same chest take time get the pt. to the OP save life.

[Sacamuelas]

Originally Posted by 52bravo

IDF has do som thing aboute chest tube air-evac, one doc from talled my that you use to must time on it. time s life so needel them.
Mattox say the same chest take time get the pt. to the OP save life.

Running that through my intoxicated 'dutch to english' translater LOL.. I get the following.

Originally Posted by 52bravo

IDF has protocols about chest tubes in air-evac scenarios. One Doc told me that you use up to much time placing it without the symptoms indicating its need. Time is life.. so needle decompress them instead. Doc Mattox says to save the precious time and get the patient to the higher level care (OP) to save his life.

How did I do Bravo?

[52bravo]

my hero sorry i know my english is bad

just one thing dr mattox is from tex,us and know to all who work in trauma care