The document describes a tension pneumothorax emergency situation where a paramedic needs to perform a decompression procedure but is delayed due to the time required to gather and prepare individual supplies. It takes the paramedic 19 seconds to prepare for the procedure during which time the patient's condition could deteriorate. The document then introduces the L-PRV solution as a way to save valuable time by simplifying and streamlining the decompression procedure when treating a tension pneumothorax in the field.

1. What would you
do with
19 seconds?

2. THE AMBULANCE SIREN
CAN BE HEARD A BLOCK
AWAY… IT HALTS AT A
BUSY INTERSECTION,
WAITING FOR THE CARS
TO CLEAR THE PATH…
SECONDS PASS
QUICKLY…5…6…7…

3. THE DRIVER TRIES TO
PULL UP TO THE
CRASH SCENE… CARS
ARE BLOCKING
ACCESS TO THE
VEHICLES… 8…9…10…

4. 11 SECONDS DISAPPEAR. THEY
FINALLY GAIN ACCESS TO THE
INJURED DRIVERS. THE DRIVER
OF THE FIRST VEHICLE IS IN
EXTREME PAIN WITH JVD AND
TRACHEAL DEVIATION. AN
ASSESSMENT REVEALS A
TENSION PNEUMOTHORAX
(PTX)…

5. THE PARAMEDIC REACHES FOR
THE NECESSARY EQUIPMENT TO
PERFORM A DECOMPRESSION OF A
PTX. HE HAS TO OPEN THE
INDIVIDUALLY PACKAGED 14
GAUGE NEEDLE, GET HIS
SCISSORS, FIND A SURGICAL
GLOVE, CUT A FINGER OF THE
GLOVE OFF… 12… 13… 14… 15…

6. FIND THE TAPE, RIP
THE TAPE, and TAPE
THE GLOVE ONTO
THE HUB … 16…
17… 18… 19…
IS IT TOO LATE…
DID THEY RUN OUT
OF TIME?

7. THIS PROCEDURE TAKES
ONE TO TWO MINUTES DUE
TO THE RUDIMENTARY
PROCEDURES CURRENTLY
USED TO PERFORM A PTX
DECOMPRESSION.

8. TIME IS CRITICLE WHEN IT
COMES TO SAVING LIVES IN
THE FIELD
THE L-PRV SOLUTION
SAVES VALUABLE
TIME…

9. SAVE THE PATIENT’S
LIFE… TREAT THE
PATIENT’S OTHER
INJURIES… MOVE ON TO
HELP OTHER INJURED
PEOPLE AT THE SCENE…
WHAT COULD THE
PARAMEDIC DO WITH
19 SECONDS?

10. 19 SECONDS…
TOO MUCH TIME TO LOSE…

11. Tension
Pneumothorax
Emergency Treatment
The L-PRV Solution
Created by
Manuel T. Rosado

12. Combat Related
Pneumothorax
 5% of all combat related deaths
are related to a Tension
Pneumothorax
Civilian Related Pneumothorax
10 - 30% of patients transported
to level 1 trauma centers receive
treatment for a Tension
Pneumothorax

13. SOURCE: Unpublished data
CDC/NCHS, National Hospital
Ambulatory Medical Care
Survey, 2007-2010.
Year Number of visits for
pneumothorax
2007 6,935,136
2008 8,292,839
2009 9,116,724
2010 9,176,258
http://www.cdc.gov/nchs/ahcd/ahcd_questionnaires.htm

14. Combat Related Deaths
31% - Penetrating head trauma
25% - Surgically uncorrectable
torso trauma
7% - Mutilating blast trauma
9% - Exsanguination
5% - Tension pneumothorax
(PTX)
1% - Airway obstruction / injury

15. Saving a Life
It is estimated that 90% of
wounded combatants can be
saved
Application of a tourniquet for
extremity hemorrhage
Rapid treatment of a PTX
The establishment of a stable
airway.

16. Rudimentary Treatment of
PTX
Procedure for field treatment
Diagnose
Delay Treatment to make
instrument
Treat PTX

17. Current Field Procedure
Finger cut from glove
Tied with suture
Or taped to hub

18. A New Way To Get
The Job Done!
Introducing
The L-PRV

19. B
C
A
(C) Once unrolled, the ROFV is free and
remains limp until pressurized air flows
outwardly from the pleural cavity. In this
manner air may pass from the patient’s
pleural cavity while precluding the passage
of air back into such pleural cavity.
(A) The needle and catheter are inserted
into the patient’s chest.
The L-PRV concept:
Patent #: 8,257,339
(B) After the needle and catheter are inserted
into the patient’s chest, the needle is
withdrawn. The catheter remains inside the
patient’s chest while the hub and Roll-Out-
Flutter Valve (ROFV) remain outside of the
body.
Pleural
cavity
Lung
2nd
Rib
2nd
Rib
2nd
Rib
1st
Rib
3rd
Rib
3rd
Rib
3rd
Rib
L_PRV_SAVES_LIVES@Yahoo.com

20. The L-PRV Applications
(World Wide)
Training and the saving of a life,
where every second counts . . .
Military: Training, Peacetime,
and Wartime
Medical Training Facilities
EMS (Adult or Child)