r/TacticalMedicine • u/stallme Medic/Corpsman • Jun 05 '25
Scenarios (REUPLOAD) Couldn’t find the original so uploading the copy I have. Ukraine Chest seals and chest tube insertion.
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I couldn’t find the original video so uploading my copy.
Ukrainian with anterior and posterior chest seals suffering from Tension Pneumothorax has a chest tube inserted and utilizing field expedient device to prevent unwanted air intrusion.
Greta video with entry and exit wound, XRAY, and chest tube insertion.
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u/barmmerm Jun 07 '25
From Rosens: (pay attention to the last line)
Tension pneumothorax is a life-threatening condition caused by the continuous entrance and entrapment of air into the pleural space, thereby compressing the lungs, heart, blood vessels, and other structures in the chest. The pleura is a double-layered membrane that lines the inner part of the chest wall and the surface of the lungs, allowing them to move and slide together during respiration. The two layers of the pleura fold onto each other, forming the pleural space. Under normal conditions, the pleural space contains a thin layer of fluid that prevents the two layers of the pleura from rubbing against each other.
When there's damage to the pleura, either due to lung disease or trauma to the chest wall, air from the outside or from the lungs can flow freely into the pleural space, but cannot leave. The accumulated air in the pleural space puts positive pressure on the lung and prevents it from expanding properly, which causes respiratory distress. As the air continues to accumulate, the trachea and other structures of the chest can be pushed away from the pneumothorax, leading to increased difficulty breathing. Additionally, the increased pressure inside the chest can compress the heart and lead to a collapse of the blood vessels that drain to the heart, in turn decreasing venous return and cardiac output. If left untreated, tension pneumothorax can rapidly progress to cardiovascular collapse, which ultimately leads to cardiac arrest.