Needle Thoracocentesis - Underpinning Knowledge

• FLAPS TWELV
• F - Feel
• L - Look
• A - Auscultate
• P - Percuss

• T - Tracheal Deviation - Preterminal Sign
• W - Wounds
• E - Surgical emphysema
• L - Laryngeal crepitus (Absent)
• V - Venous Distension

• Tachycardia
• Tachypnoea
• Hypoxia
• Patient Distressed

• Intercostal vascular damage
• Nerve damage
• Incorrect placing may damage the lung
• Less effective in patients with substantial fatty chests / muscular - consider mid-auxilla 4/5 intercostal space for this.

If the patient is intubated, check that the tube placement to make sure that R main bronchus is not only being ventillated.

Extreme caution should be exercised with bilateral chest decompression, in patients who are not being ventillated with positive pressure ventillation.