Needle Decompression Kit

[LBB]

Ok I have a simple question.

What are these needle decompression kits for and how do you use them?

I got some in my new first aid kit, and no I am not using them, but I would like to know how they are being used.

[TacAir]

Given a casualty or a Soldier acting as a casualty with severe thoracic trauma in a simulated combat environment. You are not in a CBRN environment.

The second leading cause of preventable death on the battlefield is a tension pneumothorax. If not identified in a casualty with a penetrating wound to the chest, it can be fatal. It is imperative that you, as a Soldier Medic, know how to effectively manage penetrating chest injuries and to recognize and treat a tension pneumothorax.

Check your DA Form 7595-14-R
P/O 8-68W13-SM-TG, Task: 081-833-3007, Perform A Needle Chest Decompression; Prehospital Trauma
Life Support (PHTLS), Revised Military Edition.

This is the training std.

http://armypubs.army.mil/eforms/pdf/a7595_14_r.pdf

Nice kit, odd that you would be issued something and given no training.

Does this answer your question?

[Medic Mentor]

I strongly believe that is part of the "kit." Consider a Bolin, Asherman, Halo , Hyfin as the second part, or a peice of plastic and some duct tape---4 x 4 is nice too. 4 by 4 is nice to wipe blood and sweat around the whole to get a better grip for the tape.

BTW I beleive that TCCC is now recc to carry 2 Bolin, Asherman, Halo , Hyfin---Entrance and Exit. If they got a hole in their chest and are worsening, sticking a needle in to decompress the chest is reasonably safe. If you are trained. Critical thing is to get all the holes sealed (not covered) sealed and then consider darting the chest. Did many in Iraq secondary to vest bombs in Northern Iraq filled with Ball bearings. A few GSWs and one 50 cal through the engine compartment and dashboard and fragmented ( I felt) and a BFH in a Iraqi civilian upper chest. Did okay too. Although his arm was a loss. Guess should have gave right-away on the road so the story went....I hate Asherman's--even though named after a Navy Corpsman that invented it. I love the Bolin's....and duct tape is pretty damn good in a pinch.

Nothing better to see the smile on the face of a young Navy corpsman or one of the Army Medics when they darted someone and they got better...oh yeah got to take the needle out to get the air to exit better! Also I carried 10 ga needles myself later when I could "secure" them.

Best way to simulate or train other than the damn expensive trainer with the ballders was

Take a tire inner tube and attache a can of fix and flat. Fiull inner tube and lay thawed pig ribs over the tire. Lay a thinner mouse pad over the ribs and now you have a decent trainer. You get the rush of air, nice simulation of palp for ribs and the po through mouse pad (skin). Pull out the needle and reseals. If you are doing a lot of training then consider two or three cans of fix a flat. The ribs are nice to actually show the nerve artery and vein that runs under the rib to stress way you go over.

[carbean]

Given a casualty or a Soldier acting as a casualty with severe thoracic trauma in a simulated combat environment. You are not in a CBRN environment.

The second leading cause of preventable death on the battlefield is a tension pneumothorax. If not identified in a casualty with a penetrating wound to the chest, it can be fatal. It is imperative that you, as a Soldier Medic, know how to effectively manage penetrating chest injuries and to recognize and treat a tension pneumothorax.

Check your DA Form 7595-14-R
P/O 8-68W13-SM-TG, Task: 081-833-3007, Perform A Needle Chest Decompression; Prehospital Trauma
Life Support (PHTLS), Revised Military Edition.

This is the training std.

http://armypubs.army.mil/eforms/pdf/a7595_14_r.pdf

Nice kit, odd that you would be issued something and given no training.

Does this answer your question?

Just out of curiosity, what is the #1 leading cause of preventable death on the battlefield?

[throwback]

Exsanguination from extremity bleed. Basically, blood loss from arm or leg trauma. It's why the TQ has become so popular in battlefield medicine as of late.

[LBB]

Nice kit, odd that you would be issued something and given no training.

It's part of a larger kit. I got a kit that has two things I can't use. So I store them until I find someone that can use them, or until I find some different use for it.

See some organizations do it a different way. For example bought the CitizenCorps Coordinator here 15 backpacks for the MRC with MRC funding of course.
These backpacks would be great for EMT's because they have an O2 tank in them, and two cheap first aid kits. Because of the lack of EMT's, this person asked the seller to have the tanks taken out. So they bought backpacks 300 dollar each without the most expensive item in them.
I would have given these tanks to local VFD's before I would waste this amount of money.

So maybe there is someone in my area that can use these items, maybe I have to find a different use for them.

And yes I got my answer.

[Medic Nemec]

It's the most expensive 14GA 3.25" catheter and sharps container combo you'll ever see. But the intended purpose is for tension pneumothorax decompression. I use them to start IV's in little old ladies at work though, but mine are only 2.75". 3" is the minimum recommended for chest needle decompression.

[jehicks87]

Given a casualty or a Soldier acting as a casualty with severe thoracic trauma in a simulated combat environment. You are not in a CBRN environment.

The second leading cause of preventable death on the battlefield is a tension pneumothorax. If not identified in a casualty with a penetrating wound to the chest, it can be fatal. It is imperative that you, as a Soldier Medic, know how to effectively manage penetrating chest injuries and to recognize and treat a tension pneumothorax.

Check your DA Form 7595-14-R
P/O 8-68W13-SM-TG, Task: 081-833-3007, Perform A Needle Chest Decompression; Prehospital Trauma
Life Support (PHTLS), Revised Military Edition.

This is the training std.

http://armypubs.army.mil/eforms/pdf/a7595_14_r.pdf

Nice kit, odd that you would be issued something and given no training.

Does this answer your question?

they quit teaching how to use NDK in the past year or so... I know when I was gearing up to deploy last year that was a big point of contention with some of us who've been in a bit longer compared to the newer kids. I was taught in basic and had a refresher two or three times after that. For whatever reason the big army doesn't want your average joe using a NDK anymore. They say leave it to the medics.

Basically... Who knows?

[TacAir]

Given a casualty or a Soldier acting as a casualty with severe thoracic trauma in a simulated combat environment. You are not in a CBRN environment.

The second leading cause of preventable death on the battlefield is a tension pneumothorax. If not identified in a casualty with a penetrating wound to the chest, it can be fatal. It is imperative that you, as a Soldier Medic, know how to effectively manage penetrating chest injuries and to recognize and treat a tension pneumothorax.

Check your DA Form 7595-14-R
P/O 8-68W13-SM-TG, Task: 081-833-3007, Perform A Needle Chest Decompression; Prehospital Trauma
Life Support (PHTLS), Revised Military Edition.

This is the training std.

http://armypubs.army.mil/eforms/pdf/a7595_14_r.pdf

Nice kit, odd that you would be issued something and given no training.

Does this answer your question?

they quit teaching how to use NDK in the past year or so... I know when I was gearing up to deploy last year that was a big point of contention with some of us who've been in a bit longer compared to the newer kids. I was taught in basic and had a refresher two or three times after that. For whatever reason the big army doesn't want your average joe using a NDK anymore. They say leave it to the medics.

Basically... Who knows?

Yup, live and learn some more I guess. The Corps has dropped the IV part of the Combat Lifesaver Course, it is skill that you need to pratice on a regular basis
to be any good/not kill the pt.
The trouble with much of the training in the military (IMO) is that it is one time training, rather being part of an going training program - but then, that would cost money and make for even more (rolls eyes) paperwork.....

[LBB]

[quote="TacAir"

Yup, live and learn some more I guess. The Corps has dropped the IV part of the Combat Lifesaver Course, it is skill that you need to pratice on a regular basis
to be any good/not kill the pt.
The trouble with much of the training in the military (IMO) is that it is one time training, rather being part of an going training program - but then, that would cost money and make for even more (rolls eyes) paperwork.....[/quote]


It's always the money vs the life of a person.

I know from German medics, that they mostly become EMT's that can work civil as an EMT, so they have to keep everything up to date.

The last one that gave me my first aid class there was the first one on scene when a couple of years a go an EOD exploded to an unarmored bus on the way to KIA.
That's when the German Armed Forces figured out that APC are better to transport the soldiers.

[Jorian]

I strongly believe that is part of the "kit." Consider a Bolin, Asherman, Halo , Hyfin as the second part, or a peice of plastic and some duct tape---4 x 4 is nice too. 4 by 4 is nice to wipe blood and sweat around the whole to get a better grip for the tape.

BTW I beleive that TCCC is now recc to carry 2 Bolin, Asherman, Halo , Hyfin---Entrance and Exit. If they got a hole in their chest and are worsening, sticking a needle in to decompress the chest is reasonably safe. If you are trained. Critical thing is to get all the holes sealed (not covered) sealed and then consider darting the chest. Did many in Iraq secondary to vest bombs in Northern Iraq filled with Ball bearings. A few GSWs and one 50 cal through the engine compartment and dashboard and fragmented ( I felt) and a BFH in a Iraqi civilian upper chest. Did okay too. Although his arm was a loss. Guess should have gave right-away on the road so the story went....I hate Asherman's--even though named after a Navy Corpsman that invented it. I love the Bolin's....and duct tape is pretty damn good in a pinch.

Nothing better to see the smile on the face of a young Navy corpsman or one of the Army Medics when they darted someone and they got better...oh yeah got to take the needle out to get the air to exit better! Also I carried 10 ga needles myself later when I could "secure" them.

Best way to simulate or train other than the damn expensive trainer with the ballders was

Take a tire inner tube and attache a can of fix and flat. Fiull inner tube and lay thawed pig ribs over the tire. Lay a thinner mouse pad over the ribs and now you have a decent trainer. You get the rush of air, nice simulation of palp for ribs and the po through mouse pad (skin). Pull out the needle and reseals. If you are doing a lot of training then consider two or three cans of fix a flat. The ribs are nice to actually show the nerve artery and vein that runs under the rib to stress way you go over.

Good post, MM. Thanks for that - I get some questions about training with the ARS/TPAK kits, and yours is the best idea I've seen.

[Mr. Salty]

they quit teaching how to use NDK in the past year or so... I know when I was gearing up to deploy last year that was a big point of contention with some of us who've been in a bit longer compared to the newer kids. I was taught in basic and had a refresher two or three times after that. For whatever reason the big army doesn't want your average joe using a NDK anymore. They say leave it to the medics.



This is interesting to me as I currently teach the combat lifesaver course to the California National Guard.

Needle decompression IS still a big part of the curriculum!

I like the trainer idea that someone posted with the beef ribs, bike tube and mousepad. In the absence of a medical "dummy" this would be a great subsitute.

One word of caution.

I notice a great many people in certain circles sporting the decomp needles as part of their kit. You really need to be properly trained in order to use these things properly!

PLEASE, PLEASE, PLEASE SEEK OUT A MILITARY MEDIC OR PARAMEDIC/ NURSE TO LEARN TO USE THIS DEVICE. YOU COULD POTENTIALLY KILL SOMEONE OR MAKE THING A WHOLE LOT WORSE IF YOU DO NOT KNOW WHAT YOU ARE DOING!


Other than that - have fun!

Mr. Salty

[JRJ]

midclavicular line, third intercostal space, whaa... MEDIC!

[LBB]

PLEASE, PLEASE, PLEASE SEEK OUT A MILITARY MEDIC OR PARAMEDIC/ NURSE TO LEARN TO USE THIS DEVICE. YOU COULD POTENTIALLY KILL SOMEONE OR MAKE THING A WHOLE LOT WORSE IF YOU DO NOT KNOW WHAT YOU ARE DOING!

Having it doesn't mean using it.
I will keep one of the two in my pack, maybe someone that can use them comes by when they are helpful.

[Medic Mentor]

Should I mention that the 14 ga is still good to use as an IV and best yet as an airway in the face of massive max facial airway.

Of course practice to your skill level and certification.

[PotatoMuncher]

Should I mention that the 14 ga is still good to use as an IV and best yet as an airway in the face of massive max facial airway.

Of course practice to your skill level and certification.

Makes for a great hook during a quick cric, too.

[Mr. Salty]

midclavicular line, third intercostal space, whaa... MEDIC!

That's good! - I like it!

Listen. in regards to the question posed earlier I wasn't trying to jump on anyone in reference to having these in your kit. I know the types that are always trying to make the point that they are somehow "better" because they have a little more training or they have the title Medic behind their name - I really am not like that.

I actually applaud the fact that the original poster was interested in what these things do and what they are for.

A good source of information about needle decompression and other interesting information can be found if you google subcourse ISO871 Edition C, Combat Lifesaver.

Mr. Salty

[IANMCDEVITT]

You hopefully won't need it to start a line................that is unless you have no other 18's or 20's.............you can run blood products through both. Nothing smaller than a 20...............I really wouldn't use a catheter that large for a line unless I had nothing else. If you miss and pull it, the friggin thing makes a hell-of-a hole and we no longer give large amounts of fluid for external bleeds in trauma. The focus has to be on good BLS skills. As for an airway, again last ditch, the 14 gauge is too tiny. Needle crics that small give you only about 2 minutes to think of something else.................

[Medic Mentor]

You hopefully won't need it to start a line................that is unless you have no other 18's or 20's.............you can run blood products through both. Nothing smaller than a 20...............I really wouldn't use a catheter that large for a line unless I had nothing else. If you miss and pull it, the friggin thing makes a hell-of-a hole and we no longer give large amounts of fluid for external bleeds in trauma. The focus has to be on good BLS skills. As for an airway, again last ditch, the 14 gauge is too tiny. Needle crics that small give you only about 2 minutes to think of something else.................

Interesting, TCCC and several other cources recc nothing less than 18 ga for blood products. I like 14 ga for IJ and EJ and used on for femoral stick (got some fluid in and got a line in the leg ---arms shredded).

14 ga for bolus fluids is great if four liters are on the deck, litter and in the HUMVEE to get some perfusion and awaiting a central line. Saw quite a few 14 used at FST/CSH and STP. Great to have a blood warmer or prewarmed fluids ( I kept IV fluid in electric blanket toasty warm).

14 ga for airway is awesome for way more than 2 minutes, I can quote you from PHTLs and several studies that yes you will eventually have untenable rise in CO2 but can be used for over 30 minutes---especially if you HAVE NOTHING ELSE!

Awesome as it was said before as a trach hook as well--nice as it reproduce hand movements similiar to intubation.

Practice within skills and certification.

My 2.75 cents.

[IANMCDEVITT]

Relax dude, you don't have to quote TCCC or PHTLS.........you just have to see about 35,000 more patient's to get the experience..........Can I ask you, have you ever run blood products? Honestly? you don't have to answer publicly.............Just think before you speak. If a book or a class tells you something, don't take it as law.........ask...........ask someone in the trauma center. We are all here to learn.

[jehicks87]

they quit teaching how to use NDK in the past year or so... I know when I was gearing up to deploy last year that was a big point of contention with some of us who've been in a bit longer compared to the newer kids. I was taught in basic and had a refresher two or three times after that. For whatever reason the big army doesn't want your average joe using a NDK anymore. They say leave it to the medics.



This is interesting to me as I currently teach the combat lifesaver course to the California National Guard.

Needle decompression IS still a big part of the curriculum!

I like the trainer idea that someone posted with the beef ribs, bike tube and mousepad. In the absence of a medical "dummy" this would be a great subsitute.

One word of caution.

I notice a great many people in certain circles sporting the decomp needles as part of their kit. You really need to be properly trained in order to use these things properly!

PLEASE, PLEASE, PLEASE SEEK OUT A MILITARY MEDIC OR PARAMEDIC/ NURSE TO LEARN TO USE THIS DEVICE. YOU COULD POTENTIALLY KILL SOMEONE OR MAKE THING A WHOLE LOT WORSE IF YOU DO NOT KNOW WHAT YOU ARE DOING!


Other than that - have fun!

Mr. Salty

Sorry, haven't checked this part of the board in a minute.

Yeah, we all thought the same thing. My good friend is a flight medic in our bn and he was seriously having fits when he had to sit through the course. It may be unit-dependent, but we were told this is the way the army does it now and that if we used an NDK we would be opening ourselves up to lots of trouble even if we did it correctly. A caveat to that was the medic giving the class did say if he weren't necessarily qualified to use one, but he was trained on it and his buddy was about to die he'd much rather take the punishment than live with the guilt. "Well, no shit Mr. Medic. Thanks for the ethics class."

Basically, I need a refresher before I'd be comfortable trying to use it to save someone's life... but it isn't that hard from what I remember. Same as CPR; I got certified years ago and can't exactly remember how it's supposed to go; 1 hour of refresher and I'm sure I'd be up to speed. If one has never been trained, I think it's crucial (I say again: CRUCIAL) to get trained up on techniques like this. It could save someone's life! Literally!

[VICTOR BRAVO]

You hopefully won't need it to start a line................that is unless you have no other 18's or 20's.............you can run blood products through both. Nothing smaller than a 20...............I really wouldn't use a catheter that large for a line unless I had nothing else. If you miss and pull it, the friggin thing makes a hell-of-a hole and we no longer give large amounts of fluid for external bleeds in trauma. The focus has to be on good BLS skills. As for an airway, again last ditch, the 14 gauge is too tiny. Needle crics that small give you only about 2 minutes to think of something else.................

Interesting, TCCC and several other cources recc nothing less than 18 ga for blood products. I like 14 ga for IJ and EJ and used on for femoral stick (got some fluid in and got a line in the leg ---arms shredded).

14 ga for bolus fluids is great if four liters are on the deck, litter and in the HUMVEE to get some perfusion and awaiting a central line. Saw quite a few 14 used at FST/CSH and STP. Great to have a blood warmer or prewarmed fluids ( I kept IV fluid in electric blanket toasty warm).

14 ga for airway is awesome for way more than 2 minutes, I can quote you from PHTLs and several studies that yes you will eventually have untenable rise in CO2 but can be used for over 30 minutes---especially if you HAVE NOTHING ELSE!

Awesome as it was said before as a trach hook as well--nice as it reproduce hand movements similiar to intubation.

Practice within skills and certification.

My 2.75 cents.

OK so you da man! Now can you please explain in common English (less US milspec acronyms) so those of us that bothered to read your post can benefit (learn) from it!

[Medic Mentor]

Relax dude, you don't have to quote TCCC or PHTLS.........you just have to see about 35,000 more patient's to get the experience..........Can I ask you, have you ever run blood products? Honestly? you don't have to answer publicly.............Just think before you speak. If a book or a class tells you something, don't take it as law.........ask...........ask someone in the trauma center. We are all here to learn.

I have seen patients as a pre hospital provider for 27 years, and a primary care provider for the last 14 of that....sort of lost count. Yes, had to hang blood twice. Once for Dengue Hemorrhagic Fever and the other trauma. BTW both with direct transfusion kits. Ran the blood thru a 16 ga in one and 14 IJ line the second. Would I run blood in a 20 ga in a extreme pinch? Maybe--I would consider Hespan (a lot of success with Hespan to get pressure up) and then larger access. I have had great luck with and even consider MAST as a tool in the tool box. Can you run blood in a 20 gauge--sure do you run an increased risk of issues-sure. Pretty rare hospitals don't have a central line or large bore arm/leg line. Usually trauma center can slam a central line while the blood is T and C and or being hooked up to a warmer. Same in Iraq. In the prehospital austere setting you use what you got, hopefully you have some large IV's.

I have worked in a Level Four ER in Hawaii and a Level One in San Diego as well as the military experience. Even set up an EMS system in a country in the South Pacific. Been published as well. But hey guess I need to relax...

The bottom line is you are a product of training plus experience plus reading constatnly and luck sometimes (a lot actually). I think the board is to throw ideas out in the open. When the SHTF/WROL/PAW folks here are looking for ideas to learn now, to give a try. In a litigation filled street here in the US of A...very different. With your family, your ass and conscious. I previosuly posted a great way to teach placing the needle, can be debated if you actually completely underside what a tesion pnuemo is that important... But I believe and have taught the placement and the basics to a soldier/Marine ect. Under the context that the person HAS to have a puncture or penatration to the thoracic cavity. Sealing the holes and being ready for the usual eventuality if the person starts worsening needle decompression is the best option. In the cases of spontan or closed pnuemos sticking a needle is for a medic with appropriate training---.

I watched a video that reminded me of a traffic accident I worked, the video was shown by Dr Hagman from OEMS (Deployment Med Int.) The soldier in early years of Vietnam stepped on a land mine/booby trap and you could plainly see that he needed to be decompressed. He ended up dying, no needles I guess and nobdy trained. At the car accident--- 20 plus years before I attended OEMS-- I worked I was not certified to decompress, I knew what to do though, knew why; had the needle ready and gave it to the Doctor that came in the second ambulance. The young Navy doctor looked at me and asked me if I was sure, I said the corpsman (that corpsman was a two tour Nam vet) that taught me said "what the hell could it hurt, any SOB that has a hole already." You see I already put a seal over the hole in the ride side of his chest, and he got worse in the 10 plus minutes while the fireman were getting the dashboard up. I watched that guy go from dying to talking. The movie I watched at OEMS class and tours in Iraq, 21 years after that MVA when I was a young medic with a scared shitless Navy Doctor, watching that old B & W movie of the young man dying needing the needle....it drives me.

What bugs me that for that 18 years I was never given a 14 ga needle in my medic bag (Unit 1 or 5, MOLLE medic bag ect) until finally 2002 plus-this GWOT thing. I did carry them in Desert Storm after my doc gave a great class and made sure we wanted and were comfortable doing the deed. It isn't like there was no Tension PNX in WW2, Korean War and Vietnam to learn from (sarcasm). So I am driven by that we finally have given out to most military (not always) but most a needle to give it a go. Finally gave them them to all medics. I am driven to train folks who want to learn the why and how to decompress a chest.

I will vehemently agree, stopping bleeding is the bottom line--this thread is about NDecompression,--but good BLS of a shitload of different strategies of stopping the red juice coming out....can save lives, hell good positioning too, I say the one thing that has made a difference in theater is TQ's and the paradigm of using them as last resort ---that was broken updating training, of course better TQ's and even data collection....would take a TQ versus a Needle anyday--statistically speaking you will probably using the TQ first.

[IANMCDEVITT]

That's cool, each have ther own experience...........Hey, though, do you mean EJ as in External Jugular ? Because, I have never, EVER seen it used..........I think you may mean a subclavian ? I no NO MEDICS, that do IJ's (Internal Jugular lines)..............External jugular is an easy cannulation, IJ takes a surgeon brother......JIM, you ever seen anyone do an IJ pre-hospital ? even in the ER ?