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Question: How exactly would a nurse with only basic medical supplies treat a collapsed lung?

(Posted by: matt on 2007-10-17 09:40:08)

Let's say the nurse had access to basic medical supplies, like a scalpel and a chest tube (the kind of supplies you'd find at a clinic but not at a hospital), but no respirator or chest xray machine. How would a nurse deal with a collapsed lung?

Posted by: alyRN on 2007-10-17, 19:55:06

I think EMTs in the field can do a needle thoracentesis for a tension pneumothorax, but that would be en route to the hospital, and has high risks. I really don't think it's within a nurse's scope of practice, and he/ she would risk losing their license doing something like that. i wouldn't do it. As an ICU nurse I would use appropriate supportive measures (O2, assess, and call code if the pt stops breathing and get them intubated) call the doctor on the case, get a chest xray to confirm, and await further orders. I have had that experience before: a pt developed a pneumothorax, developed difficulty breathing, and the MD had to be called in to place a chest tube. Had the pt been unstable, the ER doc or any in-house doc would be there to place the chest tube. Hope your questions are answered!

Posted by: Spirit Girl on 2007-10-17, 09:48:04

If you knew how to insert a chest tube, you would know without an xray if it worked because the patient's breathing would improve. You wouldn't need a respirator for a collapsed lung alone (pneumothorax). And the xray only confirms the site placement, it doesn't change the actual outcome. If the patient's breathing isn't getting better, you may not be in correctly. There is a certain noise that is made when I chest tube is inserted correctly. Assuming the nurse knew how to insert a chest tube, that nurse would also know what sound to listen for at the time of insertion.

Posted by: Old School on 2007-10-17, 09:56:01

Common sense/ medical-legal question. By using the term nurse I assume that you mean a licensed registered nurse vs. vocational nurse, vs. medical assistant. The answer for all of these people is the same. First perform life saving steps (ABC). As a part of this may to treat serious open wounds (only to save the life). Put the person in the most comfortable position. Call 9-1-1. This is what happens in all medical clinics within the United States of America. A important key word you used is "clinic ". If you were in the out-back of some country or at sea where you could not be rescued with the time that this injured is to die then it would be appropriate to take advanced actions; chest tube, but likely the extent of injury would likely take it terminal course inspite any humble actions by an inexperienced medical aide person.

Posted by: crocolyle10 on 2007-10-17, 10:06:43

Insertion of the tube is not enough. You have to create a vaccuum in order for the lung to re-inflate. You could try sucking on the tube, but that would not last too long. Perhaps a vaccuum cleaner with some holes placed in the tube to lessen the suction just enough to inflate the lungs until proper help arrives.

Posted by: AAcid on 2007-10-20, 01:58:39

Most likely through supportive measures to stabilize the airway and breathing until the person could be transferred. For instance, they may be able to insert an ET tube and assist ventillations with a BVM. I can't guarantee what the nurses are legally allowed to do in each state, but in the worst case, e.g. they cannot tube a pt., even ventilations can help a pt. until other personnel arrive.