b. Procedures for Needle Chest Decompression. To perform a needle chest
decompression, complete the following steps taking care NOT to injure the casualty
Gather equipment. You will need the following items:
(b) Large bore needle (12 to 14 gauge).
30 to 50 ml syringe.
(d) Iodine swab.
(e) DD Form 1380 (Field Medical Card).
(2) Verify the presence of pneumothorax. Do this by checking for
indications of the condition.
Correct assessment is essential. If a needle is inserted into a normal
chest, the casualty will almost certainly develop pneumothorax.
(a) Ask the casualty if there is a sharp pain on the affected side. Ask
for any information related to the condition; for example, pain, trauma, or difficulty in
(b) Look for signs and symptoms of shock--decreased temperature;
weak, thready pulse; rapid, shallow respirations; etc.
(c) Check for lack of chest excursion by observing the rising and falling
of the chest during the casualty's respirations. Also, compare chest excursion on both
sides of the chest to see if the chest rises and falls equally on both sides.
(d) Look for mediastinal (the mass of organs and tissues separating
the two lungs) shift. Two signs of mediastinal shift are a tracheal deviation and/or
distention of the jugular vein.
(e) Look for unilateral distention (change affecting one side) in this
1 Place one hand on the affected area.
2 Place the other hand on the unaffected side.