Needle Chest Decompression?

[mwboswell]

Okay, in alot of these "trauma" classes that are taught to nurses, and on the CEN exam, knowledge about tension PTX is taught and expected to be part of the ER nurses knowledge base. Signs/symptoms and treatment (needle decompression)....

so my question is this, as much as ER nursing education (inservice, conferences, lectures, CEN preps) talk about this, when was the last time an ER nurse actually performed needle chest decompression.

CAVEAT: I am not referring to those who might also work pre-hospital or EMS or HEMS; typically these people do it a lot. I'm just wondering about the ER folks.... any comments?

-Mark Boswell

MSN FNP-BC CEN CFRN CTRN CPEN NREMT-P

"Support CEN certification and your local ENA"

[gonzo1, ASN, RN]

7 years in ER, multiple locations. Never seen it done. I think that the CEN people just want you to know that it can be done and someone might come in with it having been done to them.

[Esme12, ASN, BSN, RN]

In the ED......even the ICU......with 32 years experience...NEVER. I do know in NICU's/premies the perform this more often...........Outside the ED/traumaflight/critical care transport.......yes. But I relied on paramedic/EMS training more than nursing skill...

[GilaRRT]

Even in the field, I've only performed pleural decompression once on a trauma code where we were working through our list of differentials (H's & T's). In the hospital, once I believe on a patient with a crushed sternum.

Contrary to popular belief. it's actually reasonably difficult to make a simple pneumothorax into a tension with a spontaneously breathing patient. Positive pressure may be a different.

[Altra, BSN, RN]

Needle decompression in the ER = chest tube inserted by physician.

[rjflyn, ASN, RN]

Having worked field and ED in 23 years now probably have done it a little over a handful of times. Maybe a couple times in the ED. That said, you find yourself in a large trauma center with any volume and doctors that like to teach they might well let you do just about anything-

[CalDiveRN]

Really? The last time was when I had hair on my head

[SummitRN, BSN, RN]

Perhaps useful in a disaster EDcapacity overload situation?

[mnbrn]

heard of it in NICU, not sure about adults

[GilaRRT]

Perhaps useful in a disaster EDcapacity overload situation?

Even then, I see no use. Needle decompression is for a very specific condition. If the condition is not identified clinically, then a needle should not be placed.

[Lunah, MSN, RN]

Never in the ED, only a few times in the field.

[MursingMedic, DNP, RN, EMT-P]

Only twice in the field. One was more for experience on an unresponsive GSW that turned code on scene (needle wasn't long enough... the boy was a biggun) and the second was a beautiful tension pneumo from an ATV rollover.

After I got my job in the ER as a GN (and now thank god as an RN) I was told promptly that there is never a time that an RN in the state of Florida will place a needle anywhere other than peripherally due to the state's nurse practice act..... No EJs or decompressions......

I'm obviously not going to argue since I am a baby nurse, but I do need to make sure I read the act just in case I was getting a bit of "EMS love" from the people I heard this from.