(4)
Rapid, shallow breathing (tachypnea).
(5)
Distended neck veins.
(6) Abnormally low blood pressure (hypotension) evidenced by a loss of
radial pulse (pulse at the wrist).
(7)
Cool, clammy skin.
(8)
Decreased level of consciousness (AVPU scale).
(9)
Visible deterioration.
(10) Loss of consciousness.
(11) Tracheal deviation (a shift of the windpipe to the right or left).
NOTE:
Tracheal deviation is a late sign of tension pneumothorax and will probably
not be observed.
b. The above signs and symptoms may be difficult to assess in a combat
situation. Therefore, assume that tension pneumothorax exists when:
(1)
The casualty has an open chest wound and
(2)
The casualty is having increasing respiratory difficulty.
4-9.
NEEDLE CHEST DECOMPRESSION
CAUTION:
A needle chest decompression is performed ONLY if the casualty has a
penetrating wound to the chest and increasing trouble breathing.
a. Gather Materials. You will need the large bore needle and catheter unit from
the first aid kit. Use the supplies in the casualty's first aid kit if possible. You will also
need a strip of tape from the spool in the kit.
NOTE:
The needle is a 14 gauge needle that is three inches in length. The rigid
metal needle is covered with a flexible catheter (tube). The needle provides
rigidity needed in puncturing the chest wall. When it is removed, the flexible
catheter remains to allow air to escape the air pocket that is causing the
tension pneumothorax.
NOTE:
Catheter/needle unit refers to the catheter with the needle inside.
MD0877
4-8
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