During the primary survey in a patient with a tension pneumothorax, we would insert an ICC

Yes, during the primary survey in a patient with a tension pneumothorax, an intercostal chest drain (ICD), also known as an intercostal catheter (ICC), would be inserted. Here are the steps:

1. Identify the need: The patient will present with symptoms such as severe shortness of breath, chest pain, rapid heart rate, and low blood pressure. A physical examination and imaging tests can confirm the diagnosis.

2. Prepare the patient: Explain the procedure to the patient and obtain informed consent. Position the patient in a semi-upright position if possible.

3. Gather equipment: You will need a chest tube kit, which includes the chest tube, a scalpel, sutures, and a drainage system. You will also need sterile gloves, drapes, local anesthetic, and antiseptic solution.

4. Prepare the site: The chest tube is usually inserted in the fourth or fifth intercostal space at the mid-axillary line. Clean the area with antiseptic solution and apply sterile drapes.

5. Administer local anesthetic: Inject the local anesthetic into the skin and deeper tissues at the insertion site.

6. Make an incision: Use the scalpel to make a small incision at the insertion site.

7. Insert the chest tube: Use a clamp to create a path for the chest tube. Then, insert the chest tube into the pleural space.

8. Secure the chest tube: Suture the chest tube in place and connect it to the drainage system.

9. Confirm placement: A chest X-ray should be done to confirm the correct placement of the chest tube.

10. Monitor the patient: Monitor the patient closely for signs of improvement or complications. The chest tube will remain in place until the pneumothorax has resolved.