Needle decompression is an emergency procedure used to relieve pressure caused by a suspected tension pneumothorax. When air becomes trapped in the pleural space, increasing pressure can rapidly impair both respiratory and circulatory function.

Tension pneumothorax is a clinical diagnosis. Do not delay treatment when a patient is exhibiting signs of respiratory compromise and deterioration. 

Assessment findings that may support the need for decompression include:

  • Severe respiratory distress
  • Unilateral diminished or absent breath sounds
  • Increasing work of breathing
  • Hypoxia
  • Signs of shock
  • Progressive deterioration following chest trauma

Common decompression sites include:

  • 4th or 5th Intercostal Space, Anterior Mid-Axillary Line — affected side (Preferred)
  • 2nd Intercostal Space, Midclavicular Line — affected side (Alternate)

Follow local protocols when selecting decompression sites. Proper landmark identification is critical to successful decompression and reducing complications.

Following decompression, reassess:

  • Breath sounds
  • Respiratory status
  • SpO2
  • Signs of continued deterioration

Improvement following decompression supports the diagnosis. Ongoing deterioration may indicate incomplete decompression, contralateral tension pneumothorax, or an alternate diagnosis. 

Remember: This is a pressure problem, When its cloesd → Open it, decompress when indicated, and reassess the patient.

PreviousNext