From teaching round–Courtesy of Mene Demestihas:
In a patient in cardiopulmonary arrest, going through the H’s and T’s can lead us to suspect a tamponade or compressive physiology as the culprit of the arrest.
In these patients placing a formal chest tube is generally frowned upon as it can be a labor-intensive process for a potentially small yield. While needle decompression of the chest has long been a standard move in this situation, Scott Weingart (@EMCrit) of the EMCrit Blog has a great post in one of his airway segments that deals with the finger thoracostomy.
The high points:
- the usual IV catheter doesn’t reach in most cases
- we don’t do a good job with an anterior approach to the needle decompression
- great video showing “how to”
~ Mene Demestihas, MD
@menelaosMD & @EmoryEM