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Mr. Freeze,
the needle is removed once the catheter is inserted, just like a 'jelco' or 'angiocath'. The catheter that remains is wire coated so it won't kink (loss of functional lumen) despite being bent. The valve fits right on to the leur lock and those two pieces remain intact until such time that a proper chest tube can be placed. The longest I've had this combo in place was 4-5 hours and as long as the patient is breathing spontaneously they can inspire deeply and valsalva to evacuate more air and at worst they have a simple pneumothorax which is well tolerated by most people and avoid a tension pneumothorax which is tolerated by few if any people, at least not for a prolonged period of time.
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'Revel in action, translate perceptions into instant judgements, and these into actions that are irrevocable, monumentous and dreadful - all this with lightning speed, in conditions of great stress and in an environment of high tension:what is expected of "us" is the impossible, yet we deliver just that.
(adapted from: Sherwin B. Nuland, MD, surgeon and author: The Wisdom of the Body, 1997 )
Education is the anti-ignorance we all need to better treat our patients. ss, 2008.
The blade is so sharp that the incision is perfect. They don't realize they've been cut until they're out of the fight: A Surgeon Warrior. I use a knife to defend life and to save it. ss (aka traumadoc)
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