SPEAR - Simplified Pneumothorax Emergency Air Release

hey guys my name's Sam and welcome to prep medic in today's video I'm going to be giving you an overview of a brand new product from North American Rescue called the spear [Music] so most of you are probably familiar with the ars needle by North American rescue I went over this in my needle decompression video but North American rescue actually just released a brand new device called the spear which is quite a lot bigger than the ARS and brings with it a little bit more functionality in my opinion so I'm not going to go over exactly what a pneumothorax is you can go to my tension pneumothorax video and my needle decompression video to watch more about the indications contraindications of needle decompression and exactly how to do it but I am going to go through the process of inserting the spear and I'm going to give you an overview of this device and some of the functionality it has over the ARS needle so right away you're gonna notice that the spear looks very similar to the RS needle they're both similarly packaged and you take them out the same way so we'll just remove the cap here and you're gonna notice that there's a tower of stuff we're on the ars needle there wasn't so as we bring this out I'll kind of explain to you what's on this device the spear stands for simplified pneumothorax emergency air release I really think that was kind of their excuse to get something that ended up spelling spear because you know obviously this thing looks like a spear and right away you're gonna notice that this needle is quite a lot bigger than the traditional ARS this is a 10 gauge needle where the old ARS was 14 they did come out with a 10 gauge later because T Triple C was telling us that that was better obviously the larger the diameter of the catheter the more air can escape and that's not going to occlude over time as easily as the 14 gauges were but in addition to width of the needle this needle is actually a little bit longer so this is 3.75 inches as opposed to three point two five inches long obviously this has a couple more parts on it than the ARS needle which just had the needle and the catheter that slid over it so on the tip here we've got a modified bezel they say it's a sharper than a normal needle so it can puncture through larger amounts of tissue especially when you have a larger diameter needle it's going to be harder to insert so they've made that extra sharp although it's not technically advertised one of the reps was telling me that you can actually take this and you can use this to make a small incision if you're having trouble getting through the initial layer skin next thing you have is you have the catheter this is the flexible plastic part that's going to go into the patient this bends and they say it won't kink very well it's got a soft tip here so it's going to reduce the amount of lung tissue damage they say I don't know how much of a difference that I'll actually make and I haven't seen a lot of studies on this so I'll get back to you with those probably in a later video when more have come out it has what they call fenestrations going down so you're going to notice on this catheter here there's little holes and those are just going to help continue to facilitate the air release from the chest so it's a little bit less likely it's going to become occluded from all of those holes obviously the end is the 14-gauge portion and that's going to be the most effective so coming up the needle you have a warlock or a twist lock here and what that does is if you're gripping it down here to do the decompression as you're exerting force downward it makes it so that the catheter can't slide over the needle it can't come there and make it so it's harder to stab into the chest so they lock it back and that's just to keep it in place beyond that you have the hub of the needle here and then on this end you have a device it's a one-way valve which they flat-out admit in their literature that it's not needed but a lot of people really wanted one it will keep some contaminants out of the needle and the other nice thing that this will do is instead of listening for a wish of air when you do the decompression it will actually make a small noise so it'll be a little bit easier to hear the air evacuating the chest I am honestly not sure how well that will work but it is an interesting idea if it does okay so the next thing I want to do is I want to go over to our mannequin and I'll actually show you the procedure for inserting this because it is quite a lot different than the traditional ARS needle alright so right next to each other you can kind of see the comparison here you can see how much larger the spear is compared to the ARS and how much more complicated this is which the complication I think serves a purpose so it's not bad but you know we'll make it just that much more difficult to perform the skill under stress so keep that in mind okay so you have two mains for your spear insertion the first one is going to be your second intercostal space right above the third rib at the midclavicular line and the second site is going to be your fifth intercostal space at the anterior axillary line right above the sixth rib the first step in inserting the spirit is to sterilize your site and I can't use this site on this dummy because there's hard plastic there so I'm going to be using the anterior site so the first step is to identify your site with your landmarks and sterilize it we're going to use an alcohol pad and I'll just simulate that I have one and you're going to sterilize that site as best you can and then you're gonna do your finger two and I'll show you kind of why that is as we start the insertion so you're going to find your site and you're going to find your third rib in this case on this site you'd find your sixth rib so it would be the rib right below the space you're going to use so I found the third rib and I'm going to take this and I'm going to stick it right on to the rib I don't want to stick it into the space yet so I stick it onto the rib and I'm going to stick it until it stops on that rib and you're going to notice there are black lines up here those are centimeter marks and that's going to measure how much adipose tissue is present on this patient and that's where you go from your depth insertion from this mark here once you hit the rib so between that rib and your Perl space is pretty much universally three centimeters in patience no matter how much muscle or adipose tissue they have so this allows the spirit to be inserted at a much more accurate depth which minimizes tissue damage of the lung is what they say at least so now that i've inserted to that line there and it's resting on the rib i'm going to take my other finger and i'm going to measure up three centimeters with that pointer finger so now that I have that measured I'm going to push it straight down into the pleural space until it gets to my finger once I get there I'm going to take this and I'm going to rotate it and I'm going to actually point the needle to the middle of the clavicle so the midclavicular area I'm going to release the catheter from the rest of the needle and I'm not going to pull the needle I'm going to push the catheter into the patient just like that I'm then going to remove the needle and I'm going to dispose of this in a safe space I'm going to take the one-way valve and I'm going to apply it to the end of this and now I'm going to tape this down so it doesn't come out and you can do that based on your policy they don't have like a specific holder for it or anything like that like I said before the one-way valve in North American rescuers even admitted this that the one-way valve is not necessary the one nice thing it does offer in this case is it protects any dirt or contaminants from getting into that tube and it also will give you a slight sound notification if air is venting from that chest at any time and once again I don't really know how well that works but it is an interesting idea and you know I'm excited to try it out your insertion in the lateral sight is going to be almost identical you're not going to really change anything but when you do rotate it you're not aiming for the clavicle you're just going straight up and then pushing the catheter in just like that I think this is a pretty neat device I'm interested to see how this functions in the field if it offers better outcomes than the standard ARS you know just with needle with needle and catheter a loan I think it offers a pretty large advantage and then I am also excited to see how this one-way valve works if that notification sound actually will function in the back of the noisy ambulance if you have any questions leave them in the comments down below I always enjoy hearing from you guys next week I'm going to be putting out a video of my off-duty EDC and I've got some new pieces of gear I'm excited to share with you guys so stay tuned for that and I will see you next week [Music]

Channel: PrepMedic

Views: 74,794

Rating: 4.9641681 out of 5

Keywords: SPEAR, North American Rescue, Needle Decompression, Medical, EMS, Emergency, Paramedic, Tactical Combat Casualty Care, Military, Police, Firefighter, EMT, Pneumothorax, Life Save, Life Saver, First Aid, Rescue, TECC, TCCC, PJ

Id: ZBC7MzNbwCk

Length: 9min 8sec (548 seconds)

Published: Sat Nov 17 2018