Pediatric Trauma - Management of Pediatric Trauma

1. Universal Precautions
2. Identify anatomical landmarks: Locate the 2nd intercostal space between the 2nd and 3rd ribs at the midclavicular line
3. Choose an appropriate size and length catheter (infants: 22 gauge, toddlers/preschoolers: 20 gauge, school-aged: 18 gauge, 14-16 gauge in adolescents)
4. Prep the insertion site with betadine or other approved cleansing agent
5. Place needle tip in the 2nd intercostal space above 3rd rib (to avoid intercostal artery and vein) in the midclavicular line
5. Insert the catheter until a rush of air is heard or felt
6. A flutter valve may be used (depending on local protocol)
7. Secure the catheter to the chest wall to prevent dislodgement
8. Follow with placement of a thoracostomy tube as soon as able