First aid measures for pneumothorax

In the tactical rescue phase, ensuring a clear airway and maintaining normal oxygen exchange is the top priority when resuscitating severely traumatized casualties and those in cardiopulmonary arrest.

Pneumothorax caused by chest wall or lung trauma is very common on the battlefield. It can be life-threatening in severe cases, but is curable if rescued in time. Any injury has a chance of survival if given proper medical attention.

For the most vulnerable parts of the body, such as the chest and abdomen, which once seemed incurable and essentially fatal in battle, reasonable and effective emergency rescue methods have gradually been developed. Therefore, it is very important to learn some first aid measures to deal with pneumothorax.

First of all, we need to have a basic understanding of pneumothorax. Pneumothorax is a condition in which gas enters the pleural cavity and causes a buildup of air, resulting in the lung lobes not being able to dilate properly and the casualty having difficulty breathing. In the field of tactical first aid, the two main types of traumatic pneumothorax commonly encountered are tension pneumothorax and open pneumothorax.

Pneumothorax is the second leading cause of death in warfare. Emergency rescue for pneumothorax directly reduces the probability of death from this potential, preventable risk.

Signs of a tension pneumothorax include: 

1. Severe shortness of breath, sudden sharp stabbing pain in the chest or shoulders, especially if the chest pain increases with inspiration.
   

2. one side of the chest appears larger than the other, asymmetrically.

3. swelling of the veins in the neck, which is a sign of jugular vein dilation

4. purple lips, neck or fingers, and no lung sounds on one side

5. dry cough, inability to breathe deeply and gasp for air, feeling like you are not getting enough air

Move personnel if head, neck, chest or airway injuries are present, unless absolutely necessary. If you must move a person, protect and stabilize the neck.

Put a pillow under the person's head, which will help close the airway.

Perform basic first aid until medical help is available. Wait to see if the person's condition improves. Seek help immediately.

First aid measures for tension pneumothorax may include the use of a pneumothorax decompression needle. This is a newly developed first aid device for tension pneumothorax that establishes the need for protection, ease of use and functionality under high pressure.

The Pneumothorax Decompression Needle is equipped with the following special features designed to help achieve a successful rescue under the most severe, demanding conditions. Please refer to the following instructions for use.

When progressive respiratory distress occurs at a physical trauma, a presumptive diagnosis of pneumothorax should be made. Please note, however, that in a war environment, the typical clinical signs described above cannot be relied upon exclusively. This is because these features may not always be present and observable. Even if they do exist, they can be difficult to identify in a noisy battlefield environment.

If a casualty does not actually have a pressure pneumothorax, then he will not suffer additional trauma from needle decompression and it will not significantly worsen his condition.

If a casualty has received penetrating trauma to the chest, then a chest seal patch may be considered first to organize the release of air from the chest wall injury. If empty air bubbles can be seen at this point in the chest cavity, then a pneumothorax has been created. As the air pressure in the pleural cavity increases, the pneumothorax will continue to develop and cause respiratory damage and shock. This condition must be treated urgently before excessive pressure squeezes the heart to the point where it loses its ability to supply blood effectively. Specific pneumothorax decompression needles can be used in the following steps.

1. Select site affected side second intercostal space midclavicular line. You should never insert a needle closer to the center of the chest than a line drawn from the nipple straight up to the collarbone.

2. Cleanse a site with antimicrobial solution

3. Remove the cap with twisting motion

4. Remove the decompression needle from case

5. Insert the needle into thr skin over the superior border of the third rib midclavicular line and direct it into the intercostal space at a ninety degree angkle to the chest wall. An audible rush of air may be heard from the needle.

6. Remove the needle and leave the catheter in place. Consider securing the catheter to the chest with tape. There is no need to create a flutter valve or attach a three-way stopcock for this catheter.

Remember to periodically reevaluate the casualty if progressive repiratory distress redevelops. Assume that the catheter is no longer effetively ventilating the pneumothorax, the rescuer may either attempt to flush the catheter with sterile or other sterile IV solution, or repeat the procedure with another deompression needle placed adjacent to the first one.

If you suspect that a tension pneumothorax is developing, remove the chest seal patch and allow air to escape.