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This is for informational purposes on decompressing a tension pneumothorax and does not replace proper training.

Locate the second intercostal space by palpating with your fingers between the 3rd and 4th ribs at the midclavicle line.

Clean the site if time permits. Remember you can treat an infection later if the patient is still alive. Use betadine or an alcohol prep to clean the site. Use one to scrub the area and the second to clean from the inside of the site to the outside.

You need an angiocath long enough to reach the injured area. At least a 3 1/4 inch long, 16 gauge angiocath to penetrate the muscle and fat layers.

Insert the angio at a 90 degree angle till you hear air escaping. Then advance the catheter into the site, and remove the needle. Advance only the catheter and remove the needle. If you attach a syringe with normal saline in it to the angiocath you will see it bubble. If you hit a rib, go over the TOP of the rib and not below it so you do not damage the neuro-vascular bundle.

With the angio in place you can use a 4 way stop cock for a one way valve or you can improvise one with a glove finger. Insert the angio through the glove before inserting in the patient and lay the glove finger over the angio leurlock. When the patient breaths in, the finger will occlude the hole. If air builds up it will force past the glove.

The hole made by the angio is very small compared to the trachea. Even if the person did not have a tension pneumothorax or you did not use a one way valve you would only create a minor pneumo which many people have without adverse affect.

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