Go Back   Professional Soldiers > TMC 14 > The Aid Bag

Reply
 
Thread Tools Display Modes
Old 10-21-2004, 18:18   #1
ender18d
Quiet Professional
 
ender18d's Avatar
 
Join Date: May 2004
Location: Pineland
Posts: 164
Cook Pneumothorax Kit

I've been asking all of the experienced field medics about this device, and so far most people haven't used it or seen it used.... Does anyone carry this in their aid-bag?

I got the chance to administer a Cook Catheter in Tampa, and had a great long talk about this device with a Doc at Ireland Army Hospital at FT Knox during my SOC-T...

The kit is light, self contained, and small... a negligable space or weight concern. Basically a nice big flexible cath with (if I remember correctly) some additional fenstrations. Inserts 2nd ICS MCL just like a standard decompression, but has built-in Heimlich and can be connected to standard pleurevac. In Tampa we used this device for definitive care on a roughly 30% spontaneous left-side pneumo, and X-rays demstrated full efficacy of treatment. The docs at both hospitals said that it is very common that this device can eliminate the need for a more invasive and painful chest-tube. This seems ideal to me for field use as an alternative to many chest-tubes, particularly for the borderline cases, such as a GSW to chest that must go on a bird, but may not display S/S of pneumo. I'd sure hate to stick a field-finger in that guy's pleural space, but this needle might be a good compromise.

Anyone have any experience or thoughts on this type of device?

http://www.armstrongmedical.com/ami/...=71&itemid=721
ender18d is offline   Reply With Quote
Old 10-22-2004, 15:20   #2
greg c
Asset
 
Join Date: Apr 2004
Location: USA
Posts: 20
I've never used the kit, but the premise is similar to most other pleural space catheter kits.

I'd be careful preemptively sticking one in a GSW that has no Sx- if he's not got a pneumothorax, you might stick that needle into the lung. You'll get a nice air return, and then you'll confidently stick that catheter right into lung tissue. Oops.
greg c is offline   Reply With Quote
Old 10-22-2004, 15:33   #3
ender18d
Quiet Professional
 
ender18d's Avatar
 
Join Date: May 2004
Location: Pineland
Posts: 164
Thank you-- that brings up another question I had...

I was trained in the schoolhouse that *anyone* with a penetrating chest wound should get a chest tube prior to air evac, even without S/S... this always seemed like *Very* aggressive treatment to me (and is one of the reasons I was particularly enthused about this cath, as a compromise for the air-evac patient)... since the chest tube is an austere environment is very far from ideal, albeit sometimes a neccessary lifesaving procedure. What guidelines are appropriate as to when either chest-tube or the cook cath should be used for an air-evac patient? I'm quite comfortable as far as treatment thresholds for ground patients, but how much more aggressive should I be if he's potentially going to be exposed to pressure changes that could gravely excacerbate a condition that's barely detectable on the ground. I can imagine how the chest tube represents less danger to a (possibly) inflated lung than the cath needle...

Any thoughts?
ender18d is offline   Reply With Quote
Old 10-22-2004, 17:08   #4
52bravo
Auxiliary
 
Join Date: Jun 2004
Location: Odense Denmark
Posts: 77
IDF has do som thing aboute chest tube air-evac, one doc from talled my that you use to must time on it. time s life so needel them.
Mattox say the same chest take time get the pt. to the OP save life.
__________________
If we are going to ask one of our combat medics to undertake a medical treatment in the middle of a firefight, then we need to be as sure as possible that the benefit resulting from this treatment is going to be worth the risk.
52bravo is offline   Reply With Quote
Old 10-22-2004, 17:31   #5
Sacamuelas
JAWBREAKER
 
Sacamuelas's Avatar
 
Join Date: Jan 2004
Location: Gulf coast
Posts: 1,898
Quote:
Originally Posted by 52bravo
IDF has do som thing aboute chest tube air-evac, one doc from talled my that you use to must time on it. time s life so needel them.
Mattox say the same chest take time get the pt. to the OP save life.
Running that through my intoxicated 'dutch to english' translater LOL.. I get the following.

Quote:
Originally Posted by 52bravo
IDF has protocols about chest tubes in air-evac scenarios. One Doc told me that you use up to much time placing it without the symptoms indicating its need. Time is life.. so needle decompress them instead. Doc Mattox says to save the precious time and get the patient to the higher level care (OP) to save his life.
How did I do Bravo?
Sacamuelas is offline   Reply With Quote
Old 10-22-2004, 17:35   #6
52bravo
Auxiliary
 
Join Date: Jun 2004
Location: Odense Denmark
Posts: 77
my hero sorry i know my english is bad

just one thing dr mattox is from tex,us and know to all who work in trauma care
__________________
If we are going to ask one of our combat medics to undertake a medical treatment in the middle of a firefight, then we need to be as sure as possible that the benefit resulting from this treatment is going to be worth the risk.

Last edited by 52bravo; 10-22-2004 at 17:37.
52bravo is offline   Reply With Quote
Old 10-22-2004, 18:39   #7
24601
Asset
 
Join Date: Jan 2004
Location: Wasilla, AK
Posts: 55
So, this is used just like a normal emergency one done with a needle and IV catheter? It looks like a good kit, nice for EMS. Not that expensive either, considering how many I know of being done back home. how large is the reservoir, and how easy is it to drain?
24601 is offline   Reply With Quote
Old 10-26-2004, 17:32   #8
swatsurgeon
Guerrilla Chief
 
swatsurgeon's Avatar
 
Join Date: Jul 2004
Location: Phoenix, AZ
Posts: 880
save money, buy the Cook decompression needle...it is wire wrapped therefore can't kink, and buy a 'mini' fish tank line valve at walmart for $1.09...this is what I carry for tactical field care. When I get back home I'll photo it and post it
T-2
__________________
'Revel in action, translate perceptions into instant judgements, and these into actions that are irrevocable, monumentous and dreadful - all this with lightning speed, in conditions of great stress and in an environment of high tension:what is expected of "us" is the impossible, yet we deliver just that.
(adapted from: Sherwin B. Nuland, MD, surgeon and author: The Wisdom of the Body, 1997 )

Education is the anti-ignorance we all need to better treat our patients. ss, 2008.

The blade is so sharp that the incision is perfect. They don't realize they've been cut until they're out of the fight: A Surgeon Warrior. I use a knife to defend life and to save it. ss (aka traumadoc)
swatsurgeon is offline   Reply With Quote
Old 11-02-2004, 11:38   #9
swatsurgeon
Guerrilla Chief
 
swatsurgeon's Avatar
 
Join Date: Jul 2004
Location: Phoenix, AZ
Posts: 880
Here is the pic I promised...the Cook Catheter "Emergency Transtracheal Airway Catheter" that is wire reinforced so it can't kink and the one way in-line fish tank valve (the exact same as the large Heimlich valve in the PTX kit only much smaller) from Walmart that I had sterilized at the hospital. Alot less money than the PTX kit they sell and infact I've been working with my Cook rep to add this to their equipment line.
Attached Images
File Type: jpg IMG_0480.JPG (34.1 KB, 123 views)
__________________
'Revel in action, translate perceptions into instant judgements, and these into actions that are irrevocable, monumentous and dreadful - all this with lightning speed, in conditions of great stress and in an environment of high tension:what is expected of "us" is the impossible, yet we deliver just that.
(adapted from: Sherwin B. Nuland, MD, surgeon and author: The Wisdom of the Body, 1997 )

Education is the anti-ignorance we all need to better treat our patients. ss, 2008.

The blade is so sharp that the incision is perfect. They don't realize they've been cut until they're out of the fight: A Surgeon Warrior. I use a knife to defend life and to save it. ss (aka traumadoc)
swatsurgeon is offline   Reply With Quote
Old 11-02-2004, 19:26   #10
24601
Asset
 
Join Date: Jan 2004
Location: Wasilla, AK
Posts: 55
Sorry to sound like an idiot (long week), but that acts as a flutter valve then?
24601 is offline   Reply With Quote
Old 11-03-2004, 06:50   #11
swatsurgeon
Guerrilla Chief
 
swatsurgeon's Avatar
 
Join Date: Jul 2004
Location: Phoenix, AZ
Posts: 880
yes, of sorts. It allows air out but not in. It is molded rubber (latex) just like the large ones we use in the hospital...like a woopie cushion, when the air goes through it the 2 'leaves' of latex separate, a pleasant noise is heard, then they naturally collapse back together preventing any air from re-entering the system. It's identical to the $150 Heimlich valve we use for chest tubes. This little valve also would allow fluid to escape as well as air. It's a temporary fix, not a permanent one. The idea of placing a chest tube in a hot zone is crazy....TCCC does not suggest that chest tubes are places in the field, just needle decompression. And best to do it with a needle that can't kink off and re-create a tention PTX and the one way valve 'closes' the system and potentially evacuates the simple PTX and 'open chest wound phenomemon'
__________________
'Revel in action, translate perceptions into instant judgements, and these into actions that are irrevocable, monumentous and dreadful - all this with lightning speed, in conditions of great stress and in an environment of high tension:what is expected of "us" is the impossible, yet we deliver just that.
(adapted from: Sherwin B. Nuland, MD, surgeon and author: The Wisdom of the Body, 1997 )

Education is the anti-ignorance we all need to better treat our patients. ss, 2008.

The blade is so sharp that the incision is perfect. They don't realize they've been cut until they're out of the fight: A Surgeon Warrior. I use a knife to defend life and to save it. ss (aka traumadoc)
swatsurgeon is offline   Reply With Quote
Old 11-03-2004, 16:39   #12
24601
Asset
 
Join Date: Jan 2004
Location: Wasilla, AK
Posts: 55
Sounds safer and better than the glove tip I've had to do before. I was looking for the chest seals we have here, but I think hubby took them to work for the platoon medic. That's what I meant by a "flutter valve".

How heavy is that, for how it's used? Is it easy to secure in place, or do you need rolled gauze around it?
24601 is offline   Reply With Quote
Old 11-03-2004, 17:55   #13
swatsurgeon
Guerrilla Chief
 
swatsurgeon's Avatar
 
Join Date: Jul 2004
Location: Phoenix, AZ
Posts: 880
the catheter weighs more than the fish valve I think...it's very light weight and since the catheter is wire wrapped, it can 'flop' over and not kink...just tape it to the skin

Were you thinking of Asherman's chest seal for open chest wounds?
I hate the glove trick especially if the gloves have powder on them...and if done incorrectly, it clogs the catheter and the tension PTX is back.
__________________
'Revel in action, translate perceptions into instant judgements, and these into actions that are irrevocable, monumentous and dreadful - all this with lightning speed, in conditions of great stress and in an environment of high tension:what is expected of "us" is the impossible, yet we deliver just that.
(adapted from: Sherwin B. Nuland, MD, surgeon and author: The Wisdom of the Body, 1997 )

Education is the anti-ignorance we all need to better treat our patients. ss, 2008.

The blade is so sharp that the incision is perfect. They don't realize they've been cut until they're out of the fight: A Surgeon Warrior. I use a knife to defend life and to save it. ss (aka traumadoc)
swatsurgeon is offline   Reply With Quote
Old 11-03-2004, 20:17   #14
24601
Asset
 
Join Date: Jan 2004
Location: Wasilla, AK
Posts: 55
Yeah, I was refering to an Asherman's chest seal. I got distracted, and ment to edit to add that. I hate the glove too, luckly we only had non powdered in the rig. I'm going to have to look at this more when/if I get hired up here and geton a rig. Going through the fire training has me a little worried.

Thank you for the info, and putting up with all my questions. I'm always looking for new ways to try things and new things to learn.
24601 is offline   Reply With Quote
Old 11-26-2004, 02:04   #15
damion18d
Asset
 
Join Date: Oct 2004
Location: San Antonio, Iraq
Posts: 5
Quote:
Originally Posted by swatsurgeon
Here is the pic I promised...the Cook Catheter "Emergency Transtracheal Airway Catheter" that is wire reinforced so it can't kink and the one way in-line fish tank valve (the exact same as the large Heimlich valve in the PTX kit only much smaller) from Walmart that I had sterilized at the hospital. Alot less money than the PTX kit they sell and infact I've been working with my Cook rep to add this to their equipment line.
How good is the connection between the cath and the fish valve? The ends of both look rigid.
As a side note. I have to say, that is really ingenius.
__________________
God keeps evil men in his care, that he may use them as tools of his vengance.
Unknown
damion18d is offline   Reply With Quote
Reply


Currently Active Users Viewing This Thread: 1 (0 members and 1 guests)
 
Thread Tools
Display Modes

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is Off
HTML code is Off

Forum Jump



All times are GMT -6. The time now is 17:55.



Copyright 2004-2019 by Professional Soldiers
Site Designed, Maintained, & Hosted by Hilliker Technologies