Simple thoracostomy in prehospital trauma management is safe and effective: a 2-year experience by helicopter emergency medical crews.

Abstract

OBJECTIVE:

To evaluate the effectiveness and potential complications of simple thoracostomy, as first described by Deakin, as a method for prehospital treatment of traumatic pneumothorax.

METHODS:

Prospective observational study of all severe trauma patients rescued by our Regional Helicopter Emergency Medical Service and treated with on-scene simple thoracostomy, over a period of 25 months, from June 1, 2002 to June 30, 2004.

RESULTS:

Fifty-five consecutive severely injured patients with suspected pneumothorax and an average Revised Trauma Score of 9.6+/-2.7 underwent field simple thoracostomy. Oxygen saturation significantly improved after the procedure (from 86.4+/-10.2% to 98.5%+/-4.7%, P<0.05). No difference exists in the severity of thoracic lesions between patients with systolic arterial pressure and oxygen saturation below and above or equal to 90. A pneumothorax or a haemopneumothorax was found in 91.5% of the cases and a haemothorax in 5.1%. No cases of major bleeding, lung laceration or pleural infection were recorded. No cases of recurrent tension pneumothorax were observed. Forty (72.7%) patients survived to hospital discharge.

CONCLUSIONS:

Prehospital treatment of traumatic pneumothorax by simple thoracostomy without chest tube insertion is a safe and effective technique.

• Authors: Daniele Massarutti, Giulio Trillò, Giorgio Berlot, Ariella Tomasini, Barbara Bacer, Loris D'Orlando, Marino Viviani, Adriano Rinaldi, Alberto Babuin, Lorenzo Burato, Elio Carchietti
• Journal: European journal of emergency medicine : official journal of the European Society for Emergency Medicine (Eur J Emerg Med) Vol. 13 Issue 5 Pg. 276-80 (Oct 2006) ISSN: 0969-9546 [Print] England
• PMID: 16969232 (Publication Type: Journal Article)

Topics

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Aircraft
• Emergency Medical Services (methods)
• Female
• Hemopneumothorax (surgery)
• Hemothorax (surgery)
• Humans
• Injury Severity Score
• Male
• Middle Aged
• Pneumothorax (surgery)
• Prospective Studies
• Thoracic Injuries (surgery)
• Thoracostomy (adverse effects)
• Wounds, Nonpenetrating (surgery)