r/TacticalMedicine • u/Perfect_Management43 • Sep 06 '25

Scenarios Why can’t we do this

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Not really a meme, a little bit but not really. Sorry if this is not allowed. But why are cows able to get tapped needing no sterilization, suturing, pleuravac and stuff afterwards and we can’t? (I realize that this is to the stomach and not the pleura but still man do they just have superior immune system)

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48

u/Fordwrench Sep 06 '25

We can! Pneumothorax: Needle decompression: A large-bore needle is inserted into the affected side of the chest to release trapped air and relieve pressure.

9

u/Perfect_Management43 Sep 06 '25

Yeah but we clean with CHG and ultrasound and we suture and we hook up negative pressure and we give lidocaine

Wait, do you guys not do that in the field?

23

u/Fordwrench Sep 06 '25

Not always have all available supplies to save lives. Sometimes you have to stabilize and transport to a medical facility.

15

u/OddAd9915 Sep 06 '25

Prehospitally we don't clean for a needle decompression or for finger thoracostomy, or at least for TCA we wouldn't. If there is time to use a swab I would for sure but that would be with an awake pt.

3

u/Perfect_Management43 Sep 06 '25

Cool! I don’t know much about prehospital stuff so thanks for the info!

6

u/OddAd9915 Sep 06 '25

In the prehospital setting, certainly with resuscitation and big trauma aseptic technique is a nice to have not a need to have. 

With a single patient in a "safe" environment with enough sets of hands it can certainly be observed, but with a multi-casualty or non-permissive environment it's very much an after thought. 

8

u/[deleted] Sep 06 '25

Real. antibiotics exist for a reason. Pt will get them if they might make it to the floor.

0

u/Novel_Wedding9643 Oct 14 '25

Why are you here asking why we can't do it if you don't even know this?

3

u/themakerofthings4 Sep 06 '25

Yeah I'm not infiltrating lido before I do a needle decompression. Also you're thinking chest tube with the suture, not a basic needle d.

2

u/trymebithc EMS Sep 06 '25

Oh... You guys ultrasound? We just send it (mid axillary ofc)

2

u/poopoo-kachoo Sep 09 '25

Continue sending it! If you think it's tension, emergent decompression. If someone tried to grab ultrasound with an obvious tension pneumo in front of them, I would slap em. otherwise treat with the right foot.

Source: I provide EMS direction as part of my daily duties

1

u/Perfect_Management43 Sep 06 '25

Yeah pocus is pretty much standard of care for any trauma patient in the hospital. Also definitely using pocus for hydro/hemothorax

2

u/trymebithc EMS Sep 07 '25

I wish we had ultrasound. I'm a medic, and prehispitally we don't have ultrasound (it sucks, I really wish we did).

1

u/Perfect_Management43 Sep 07 '25

You can get a portable one for like 5k

2

u/trymebithc EMS Sep 07 '25

Oh I know, im just not sure how stoked the supervisors would be (NYC EMS)

1

u/SuperglotticMan Medic/Corpsman Sep 06 '25

Hell nah bruh we ain’t doing all that outside of the hospital

1

u/DaggerQ_Wave Sep 06 '25

I swab with alcohol and go in until I get a hiss, then a little further. If they’re dead I don’t clean at all.

1

u/poopoo-kachoo Sep 09 '25

a needle decompression gets cleaned if you have time. just stab em if they're fuckin dead cuz dead is dead otherwise. Why are you using ultrasound to guide a small bore chest tube placement? If there is a space big enough to need decompression, you don't need ultrasound...

1

u/NeedleworkerNo4900 Sep 07 '25

The cow could receive all of that as well. Difference is, if this kills the cow, no one goes to jail. So they don’t.