Abstract
For decades, most prehospital clinicians have only been armed with needle thoracostomy
to treat a tension pneumothorax, which has a significant failure rate. Following recent
changes by the US military, more ground and air transport agencies are adopting simple
thoracostomy, also commonly referred to as finger thoracostomy, as a successful alternative.
However, surgical procedures performed by prehospital clinicians remain uncommon,
intimidating, and challenging. Therefore, it is imperative to adopt a training strategy
that is comprehensive, concise, and memorable to best reduce cognitive load on clinicians
while in a high-acuity, low-frequency situation. We suggest the following mnemonic
to aid in learning and retention of the key procedural steps: FINGER (Find landmarks;
Inject lidocaine/pain medicine; No infection allowed; Generous incision; Enter pleural
space; Reach in with finger, sweep, reassess). This teaching aid may help develop
and maintain competence in the simple thoracostomy procedure, leading to successful
treatment of both a tension pneumothorax and hemothorax.
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Article info
Publication history
Published online: August 28, 2022
Footnotes
The views expressed in this article are those of the authors and do not reflect the official policy or position of the Medical College of Georgia, University of New Mexico School of Medicine, Department of the Army, Department of Defense, or the U.S. Government.
The authors would like to thank and acknowledge Tyler Christifulli for design and use of the landmark graphic.
Identification
Copyright
© 2022 Air Medical Journal Associates. Published by Elsevier Inc. All rights reserved.
