Advertisement

A comparison study of chest tube thoracostomy: Air medical crew and in-hospital trauma service

      This paper is only available as a PDF. To read, Please Download here.
      Chest tube thoracostomy (CTT) is not frequently performed by non-physician—staffed air medical crews (AMC) due to concern regarding safety, efficiency and training requirements. This study compared two groups of patients requiring CTT, one group with insertion performed by an AMC and the other by a physician trauma service (TS) in the emergency department on patient arrival. The CTT of 172 patients managed at a Level I trauma center between October 1988 and September 1990 were reviewed. Seventy-two patients were managed by the AMC and received CTT in a prehospital setting; the air medical personnel placed the chest tube cleanly in all cases. Chest tubes placed by AMC were removed within 48 hours of transport to minimize infection risk. One hundred patients requiring CTT in the hospital setting were randomly selected from the trauma registry during a similar time span. The study compared the patients' Injury Severity Scores (ISS), and trauma scores, any placement complications and the overall mortality. While the AMC often treated patients with higher acuity, as reflected by ISS and trauma scores and overall higher mortality, the rate of complications between CTT performed by AMC and TS was similar. Appropriately trained AMC can safely perform CTT without putting patients at increased risk.

      Key words

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Air Medical Journal
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Moylan JA
        Impact of helicopters on trauma care and clinical results.
        Ann Surg. 1988; 208: 673-678
        • Baxt WG
        • Moody P
        • Cleveland HC
        • et al.
        Hospital-based rotorcraft aeromedical emergency care services and trauma mortality: a multicenter study.
        Ann Emerg Med. 1985; 14: 859-864
        • Anderson TE
        • Rose WD
        • Leicht WJ
        Physician staffed helicopter scene response from a rural trauma center.
        Ann Emerg Med. 1987; 16: 58-61
        • Hicks TC
        • Danal DF
        • Thomas DM
        • et al.
        Resuscitation and transfer of trauma patients: a prospective study.
        Ann Emerg Med. 1982; 11: 296-299
        • Millikan JS
        • Moore EE
        • Stiner E
        • et al.
        Complications of tube thoracostomy for acute trauma.
        Am J Surg. 1980; 140: 738-741
        • Eddy AC
        • Luna GK
        • Copass M
        Emphyema thoraces in patients undergoing emergent closed tube thoracostomy for thoracic trauma.
        Am J Surg. 1989; 157: 494-497
        • Daly RC
        • Mucha P
        • Pairolero PC
        • et al.
        The risk of percutaneous chest tube thoracostomy for blunt thoracic trauma.
        Ann Emerg Med. 1985; 14: 865-870
      1. (Thorofare, N.J.)
        • National Flight Nurses Association
        Flight Nurse Advanced Trauma Course.
        1990