Heimlich Valve - Forum

Dottore

Heimlich Valve - Ärzteforum

Post#1 »

How is your experience with the use of "Heimlich Valve" to management traumatic pneumotorax?


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Surgeon

Re: Heimlich Valve - Ärzteforum

Post#2 »

I used these quite a bit when I was a resident for traumatic and spontaneous ptx.
They work well w/ minimal discomfort. They are also easy to take out and rarely does the ptx "recur" when the tube is removed.

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Billroth

Re: Heimlich Valve - Ärzteforum

Post#3 »

Heimlich valves work well on the roadside, where a bottle would be in the way and dangerous, but I like to see what is coming out of my drains, and the best way to see that is with an underwater seal drain. The valves can gum up after a while. You still need a bottle or something to catch what comes out.

Scalpel

Re: Heimlich Valve - Ärzteforum

Post#4 »

The commercial Cook Heimlich valves are fairly large and I have not had them gum up. I connect them to Foley (urinary) catheter bags--I think this is the application where I have to cut off the Foley cath connector back to the Foley tubing to get a good seal. It is true that you can't tell if there is air still leaking, but I close the 2 way valve that comes with the Cook set. If the patient gets dyspneic, I have them unhook it. If they don't get dyspneic, I get a chest X-ray the next day. If the chest X-ray is okay I remove the tube.

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A Doctor

Re: Heimlich Valve - Ärzteforum

Post#5 »

Regarding Heimlich valves, a few weeks ago I was covering another surgeons practice who unsuccessfully used a heimlich vavle then asked the nurses to place him on suction. I was called to see him regarding increasing chest pain and shortness of breath I got there about the same time as the xray I ordered.

While I was examining the patient I noticed that the Heimlich valve was inline with the sution and on direct observation the pressure seem to have to build up before it could decompress. Even though the xray didn't clearly show any change from the AM xray he felt much better when I removed the offending valve from the circuit.

Surgical student

Re: Heimlich Valve - Ärzteforum

Post#6 »

I've left them in when I have put patient's on waterseal drainage (Pleura-vac or Thoroseal) and suction without any problems.

I did once put the valve backwards which obviously doesn't work.

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Treatment guru

Re: Heimlich Valve - Ärzteforum

Post#7 »

Do you leave the catheter bags open? - 'cos it wouldn't take much of an air leak to fill one and then your valve will cease to work. If you leave your bag open won't any fluid leak onto the floor? An under water seal drain is safe, cheap and effective, and has none of these disadvantages. We take one Xray prior to drain insertion to confirm the presence of pneumo/haemo (unless there is a tension of course), and then watch the drain. Once it has stopped bubbling and swings less than an arbitrary 6cm (say 2 inches) we listen to the chest, if clear remove the drain and send the patient for a check Xray prior to discharge. Many folk are in 24 hours only. The walk to X ray dept is good physio! This is more or less the policy in most South African hospitals and it seem quick cheap and efficient. Obviously drains for non trauma reasons can be more tricky as the underlying lung is pathological.

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