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IFAK with Chest Darts- are they for everyone?

11/24/2014

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Have you received training to perform a Needle thoracentesis (Pleural Decompression) AKA, the use of a decompression needle? A Tension Pneumothorax is a medical emergency which requires timely intervention. 


PictureDecompression Needle
A decompression needle is usually a 14 to 16 gauge, 3.25” catheter needle used to penetrate the chest wall and pleural cavity thereby releasing built up air pressure.  This process is referred to as a Needle thoracentesis or pleural decompression.  There are many dangers associated with untrained personnel attempting to utilize a chest decompression needle for the treatment of a tension pneumothorax. 

One-way chest seals are an alternative to decompression needles for treatment of a tension pneumothorax. In June 2013 USCENTCOM approved the following...

PictureOpen Chest Wound
recommendation by the required two-thirds majority of the Committee on TCCC.

“All open and/ or sucking chestwounds should be treated by immediately applying a vented chest seal to cover the defect. If a vented chest seal is not available, use a non-vented chest seal. Monitor the casualty for the potential development of a subsequent tension pneumothorax. If the casualty develops increasing hypoxia, respiratory distress, or hypotension and a tension pneumothorax is suspected, treat by burping or removing the dressing or by needle decompression”

A pneumothorax is a collapsed lung.  Pneumothorax occurs when air leaks into the plural space between your lungs and chest wall.

A tension pneumothorax is the progressive build-up of air within the pleural space usually due to an open wound, caused by a blast injury, gunshot wound, knife stabbing etc. to the chest area. Air enters the pleural cavity and is trapped during exhale; air pressure builds within the thorax higher than external atmospheric pressure which compresses the lung.  This compression can place pressure on the heart and lung.

PictureSierra12 IFAK
Sierra12 IFAK was built to address the 3 leading causes of preventable combat death:

1)Extremity Hemorrhage 60%

2)Tension Pneumothorax 33%

3)Airway Obstruction 6%

This IFAK contains tools which are designed for quick and intuitive application.  If you don't know how to use a decompression needle that doesn’t mean you can’t render aid to someone with a tension pneumothorax. This kit contains a total of 4 chest seals (2 HALO, 1 Asherman w/1-way valve, 1 Vaseline occlusive dressing).  The ASHERMAN chest seal is specifically designed to treat an open Pneumothorax and help prevent the onset of a Tension Pneumothorax in open chest injuries.  The Asherman seal utilizes a one-way valve which allows air and blood to escape while preventing air from reentering through the wound site.

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Needle Decompression is not to be discounted. A tension pneumothorax can be present in either a closed or open chest injury.  We know that internal and crush injuries do happen that will require a needle thoracentesis procedure, we believe that chest darts just require a higher level of training to use them effectively. In a closed chest injury with a tension pneumothorax a device such as a chest decompression needle would be an appropriate method of treatment. 


Often time’s equipment and the responses are evaluated based on the level of training and likelihood on encountering a type of injury.  This specific IFAK was stocked based on the 80%-20% theory. This IFAK is addressing the majority of injuries found on the battle field. The Chest seals are very intuitive and address a very large percentage of battle field chest wounds such as a sucking chest wounds from a gunshot wound which can lead to a tension pneumothorax. It is highly suggest that everyone seek out qualified Tactical Combat Casualty Care classes. If someone chooses to carry a specific lifesaving piece of equipment, they should at least understand how to effectively use it.

Components included in the Sierra12 IFAK:

Standard IFAK Contents:

·         SOF® Tactical Tourniquet-W (1)

·         4 inch Olaes® Bandage (1)

·         Petrolatum Gauze occlusive dressing (1)

·         Nasopharyangeal airway 28F w/ Lube (1)

·         Pair of Gloves, nitrile, Size: Extra-large (1)

·         2 inch Tape, surgical (1)

·         Laerdal Face shield  (1)

·         Trauma shears 5.5"  (1)

·         CCT Card (1)

Upgrade IFAK Contents:

·         Includes all the above +

·         Tourniquet Case (1)

·         ASHERMAN chest seal (1)

·         HALO Chest seal (contains 2)

·         CeloxTM Rapid Ribbon Hemostatic gauze

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