1. Chest tube procedure for making a subcutaneous tunnel
Chest tube procedure for making a subcutaneous tunnel. The skin incision is lower than the thoracic wall entry site. If a patient has signs of tension pneumothorax (acute shortness of breath, hypotension, distended neck veins, tachypnea, tracheal deviation) before a chest tube is placed, urgent treatment is needed. Insert a 14-gauge needle into the chest in the 2nd ICS in the midclavicular line to rapidly decompress the tension pneumothorax and proceed with chest tube insertion. Do not wait for chest x-ray confirmation before inserting a needle into the chest if the diagnosis of tension pneumothorax is suspected. (Reprinted, with permission, from: Gomella TL [ed] Neonatology: Basic Management, On-Call Problems, Diseases, Drugs, 5th ed. McGraw-Hill, 2004.)
Source: Chapter 13. Bedside Procedures, Clinician's Pocket Reference: The Scut Monkey, 11e
Citation: Gomella LG, Haist SA. Clinician's Pocket Reference: The Scut Monkey, 11e; 2007 Available at: Accessed: October 29, 2017
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