When using a small-bore catheter with a one-way valve such as a Heimlich valve, how can you determine definitively that there is or is not a small air leak?
a. Connect to an underwater seal.
b. Increase the FiO2 and note clinical chang-es.
c. Listen for air movement.
d. Watch the valve to see if it moves.
ANS: A
It is difficult to determine whether a Heimlich valve has an ongoing leak unless it is placed to underwater seal. This procedure can be done in the emergency department by placing the Heim-lich valve into a cup of water or by placing it in-line with a water-seal chamber to see whether an air leak is continuing after lung expansion.
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