NEEDLE THORACO S TOMY HEIMLICH’ MANEUVER
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Transcript of NEEDLE THORACO S TOMY HEIMLICH’ MANEUVER
NEEDLE THORACOSTOMYHEIMLICH’ MANEUVER
SKILL LABORATORYRESPIRATORY SYSTEM
YANA AKHMADARTO YUWONO
PRAYUDI SANTOSO
TOPIC NEEDLE THORACOSTOMY
HEIMLICH’ MANEUVER
OBJECTIVE
BE ABLE TO PERFORM PROCEDURE OF NEEDLE THORACOSTOMY AND HEIMLICH’ MANEUVERKNOW INDICATIONS AND GOAL OF THE PROCEDURES
INTRODUCTION
NEEDLE THORACOSTOMY PROCEDURE FOR EMERGENCY
DECOMPRESSION OF THE CHEST UNTIL A CHEST TUBE CAN BE INSERTED
PATIENT WITH LIFE THREATENING TENSION PNEUMOTHORAX
PNEUMOTHORAX
THE PRESENCE OF AIR WITHIN PLEURAL SPACE
CATAGORIES :
• TRAUMATIC (ACCIDENTAL OR IATROGENIC)• SPONTANEOUS (WITHOUT AN OBVIOUS CAUSE)
- PRIMARY (NO UNDERLYING LUNG DISEASE)
- SECONDARY (HAS A PREDISPOSING LUNG DISEASE)
MECHANISMCOMMUNICATION BETWEEN THE ALVEOLI
AND THE PLEURAL SPACE (BRONCHOPLEURAL FISTULA)
COMMUNICATION BETWEEN THE ATMOSPHERE AND THE PLEURAL SPACE (PENETRATING CHEST WOUND OR TRAUMATIC)
CLINICAL MANIFESTATIONDEPEND ON THE VOLUME OF THE
PNEUMOTHORAX AND PRESENCE OR ABSENCE OF UNDERLYING LUNG DISEASE
SYMPTOM - DYSPNEA - CHEST PAIN : SHARP AND
ABRUPT
SMALL PNEUMOTHORAX : - ASYMPTOMATIC
TENSION PNEUMOTHORAX
OCCUR WHEN AIR IN THE PLEURAL SPACE EXCEEDS ATMOSPHERIC PRESSURE
MEDIASTINAL SHIFT TO CONTRALATERAL SIDE, PLACES TORSION ON THE INFERIOR VENA CAVA, VENOUS RETURN DECREASE, CARDIAC OUTPUT DECREASE, AND HIPOTENSION RESULT
THE LUNG CONTINOUS TO COMPRESS, INTRA PULMONARY SHUNTING THROUGH THE COLLAPSED LUNG CAUSED HYPOXEMIA
LIFE THREATENING
TREATMENT IS EMERGENCY DECOMPRESI OF THE CHEST
NEEDLE THORACOSTOMY
Learning Guide for needle thoracostomyA. Preparation the tools : needle no.16,
syringe 3cc, gloves, cotton swab, povidon iodine, normal salin, com, kidney basin, measuring glass with water tube, tape.
B. CLIENT ASSESSMENT1. Greet client respectfully and with
kindness2. The patient should be given adequate
explanation about needle thoracostomy and the goal or expected result of needle thoracostomy (Briefly)
C. PERFORMING NEEDLE THORACOSTOMY
1. Wash your hand and dry it with dry towel. Put on the gloves.
2. Clean the skin around the second intercostals space at the midclavicular line, using povidone –iodine solution. Use a circular motion, starting at the center and working outward.
3. Fill the syringe with 2 cc sterile normal saline
4.
Insert a sterile 16G or larger needle with attached syringe immediately over the superior portion of the rib and through the tissue covering the pleural cavity while aspirating
5.
When air is aspirated, advance catheter completely, and withdraw syringe. Withdraw syringe following connect the inserted needle with tubing immediately and place the other end of tubing in a measuring glass filled with water
6.
Leave the needle in place until a chest tube can be inserted.
HEIMLICH’ MANEUVER (ABDOMINAL THRUSTS)
INTRODUCTIONFOREIGN BODY AIRWAY OBSTRUCTION - VOMITUS, FOOD BOLUS, OTHER
MAY CAUSE EITHER PARTIAL OR COMPLETE OBSTRUCTION
PARTIAL OBTRUCTION : CONSCIOUS AND COUGHING
COMPLETE OBSTRUCTION : CANNOT TALK, COUGH OR BREATH
THE PATIENT CLUTCHES AT HIS/HER THROAT
(UNIVERSAL DISTRESS SIGNAL OF FOREIGN
BODY OBSTRUCTION) NEED OF EMERGENCY INTERVENTION THE PROCEDURE OF CHOICE FOR
CLEARING A FOREIGN BODY FROM AIRWAY
OBSTRUCTION : - ABDOMINAL THRUSTS
(HEIMLICH’MANEUVER) ADULT, CHILDREN - BACK BLOWS - CHEST THRUSTS
INFANT, ADVANCED PREGNANCY
HEIMLICH’ MANEUVERTHE PROCEDURE OF CHOICE FOR CLEARING
A FOREIGN BODY FROM AIRWAY
OBSTRUCTION :
THIS PROCEDUR NORMALY ARE FOLLOWED BY A MANUAL CHECK AND REMOVAL OF ANY OBSTRUCTING FOREIGN MATERIAL
FORCEFUL THRUSTS APPLIED TO THE EPIGASTRIUM CAN DISLODGE AN OBSTRUCTION CAUSED BY FOREIGN BODY
QUICK THRUSTS TO THE ABDOMEN
DISPLACE DIAPHRAGM UPWARD
INCREASING INTRATHORACIC PRESSURE AND CREATING EXPLUSIVE EXPIRATORY AIRFLOW
EXPEL THE FOREIGN BODY FROM THE AIRWAY
Learning Guide for Heimlich ManuverNo. STEPS/TASK
A. CLIENT ASSESSMENT
1. Greet client respectfully and with kindness
2 The patient should be given adequate explanation about Heimlich manuver and the goal or expected result Heimlich maneuver (Briefly)
B. PERFORMING ABDOMINAL THRUSTS (HEIMLICH’ MANUVER)
1. Standing behind the patient, wrap both arms around his waist.
2. Place your fist int the center of his abdomen, midway between the umbilicus and the xiphoid process. Rest the thumb side of your fist aginst his epigastrium and then grasp your fist with your other hand.
3. Using a quick motion, thrust your fists inward and upward
4. Repeat the process until the obstruction is removed