Highlights
- •We examine the use of thoracostomy in the air medical environment by flight nurses and paramedics.
- •We report on a series of 250 patients who underwent thoracostomy and review their outcome, survival, and complication rate.
- •Background, symptomatology, and interventions for pneumothoraces are covered.
Abstract
Objective
The use of thoracostomy to treat tension pneumothorax is a core skill for prehospital
providers. Tension pneumothoraces are potentially lethal and are often encountered
in the prehospital environment.
Methods
The authors reviewed the prehospital electronic medical records of patients who had
undergone finger thoracostomy (FT) or tube thoracostomy (TT) while under the care
of air medical crewmembers. Demographic data were obtained along with survival and
complications.
Results
During the 90-month data period, 250 patients (18 years of age or older) underwent
FT/TT, with a total of 421 procedures performed. The mean age of patients was 44.8
years, with 78.4% being male and 21.6% being female; 98.4% of patients had traumatic
injuries. Cardiopulmonary resuscitation was required in 65.2% of patients undergoing
FT/TT; 34.8% did not require cardiopulmonary resuscitation. Thirty percent of patients
exhibited clinical improvement such as increasing systolic blood pressure, oxygen
saturation, improved lung compliance, or a release of blood or air under tension.
Patients who experienced complications such as tube dislodgement or empyema made up
3.4% of the cohort.
Conclusion
The results of this study suggest that flight crews can use FT/TT in their practice
on patients with actual or potential pneumothoraces with limited complications and
generate clinical improvement in a subset of patients.
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References
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Article info
Publication history
Published online: May 17, 2016
Identification
Copyright
Copyright © 2016 by Air Medical Journal Associates
