Clean the insertion site.
(a) Remove the swab from the wrapper.
(b) Clean from the insertion site outward in a circular motion for 3 to 4
Insert the needle with the attached syringe.
(a) Place the needle tip, bevel up, on the insertion site, centered on the
(b) Lower the proximal end of the needle to permit the tip to enter the
skin over the third rib.
(c) Insert the needle into the skin over the third rib until you have
penetrated the pleura. When the pleura is penetrated, you will feel a "POP" followed by
expulsion of air through the needle.
(6) Aspirate air. Aspirate as much air as necessary to relieve the patient's
Avoid puncturing blood vessels and nerves!
Withdraw the needle.
(a) Look for signs of respiratory relief as evidenced by the absence of
the symptoms of pneumothorax.
(b) Withdraw the needle along the angle of insertion.
(8) Record. If you are in a field setting, record the treatment on the Field
1-16. CATHETER-OVER-NEEDLE CHEST DECOMPRESSION
Perform a catheter-over-needle chest decompression. To do this procedure
correctly, you must perform the following steps in sequence being careful not to cause
further injury to the casualty.
a. Gather your equipment. You will need the following items:
Catheter-over-needle device (12 to 14 gauge).