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Finger thoracostomy

Theodore T Redman, Elliot M Ross
BACKGROUND: Cadaver training for prehospital surgical procedures is a valid training model. The limitation to date has been that perfused cadavers have only been used in wet laboratories in hospitals or university centers. We endeavor to describe a transportable central-perfused cadaver model suitable for training in the battlefield environment. Goals of design were to create a simple, easily reproducible, and realistic model to simulate procedures in field and austere conditions. METHODS: We conducted a review of the published literature on cadaver models, conducted virtual-reality simulator training, performed interviews with subject matter experts, and visited the laboratories at the Centre for Emergency Health Sciences in Spring Branch, TX, the Basic Endovascular Skills in Trauma laboratory in Baltimore, MD, and the Fresh Tissue Dissection Laboratory at Los Angeles County and University of Southern California, Keck School of Medicine, Los Angeles, CA...
September 2018: Journal of Emergency Medicine
Frank K Butler, John B Holcomb, Stacy Shackelford, Harold R Montgomery, Shawn Anderson, Jeffrey S Cain, Howard R Champion, Cord W Cunningham, Warren C Dorlac, Brendon Drew, Kurt Edwards, John V Gandy, Elon Glassberg, Jennifer Gurney, Theodore Harcke, Donald A Jenkins, Jay Johannigman, Bijan S Kheirabadi, Russ S Kotwal, Lanny F Littlejohn, Matthew Martin, Edward L Mazuchowski, Edward J Otten, Travis Polk, Peter Rhee, Jason M Seery, Zsolt Stockinger, Jeremy Torrisi, Avi Yitzak, Ken Zafren, Scott P Zietlow
This change to the Tactical Combat Casualty Care (TCCC) Guidelines that updates the recommendations for management of suspected tension pneumothorax for combat casualties in the prehospital setting does the following things: (1) Continues the aggressive approach to suspecting and treating tension pneumothorax based on mechanism of injury and respiratory distress that TCCC has advocated for in the past, as opposed to waiting until shock develops as a result of the tension pneumothorax before treating. The new wording does, however, emphasize that shock and cardiac arrest may ensue if the tension pneumothorax is not treated promptly...
December 0: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
Ryan P Dumas, Kristen M Chreiman, Mark J Seamon, Jeremy W Cannon, Patrick M Reilly, Jason D Christie, Daniel N Holena
INTRODUCTION: Emergency department thoracotomy (EDT) must be rapid and well-executed. Currently there are no defined benchmarks for EDT procedural milestones. We hypothesized that trauma video review (TVR) can be used to define the 'normative EDT' and generate procedural benchmarks. As a secondary aim, we hypothesized that data collected by TVR would have less missingness and bias than data collected by review of the Electronic Medical Record (EMR). METHODS: We used continuously recording video to review all EDTs performed at our centre during the study period...
September 2018: Injury
Pritchard Jodie, Hogg Kerstin
A short cut review was carried out to see if 'finger' thoracostomy is a safe and effective method of treating a tension pneumothorax in a pre-hospital setting. Five relevant papers were found looking at this technique in the pre-hospital setting. The author, date and country of publication, patient group studied, study type, relevant outcomes, results study weaknesses of these papers are tabulated. This technique appears to be safe and effective when performed by trained physicians in a pre-hospital setting...
June 2017: Emergency Medicine Journal: EMJ
Pritchard Jodie, Hogg Kerstin
A short cut review was carried out to see if 'finger' thoracostomy was a safe and effective procedure to use in the pre-hospital setting in patients with traumatic cardiac arrest. Three relevant papers were found describing the use of this technique in the pre-hospital setting. The author, date and country of publication, patient group studied, study type, relevant outcomes, results study weaknesses of these papers are tabulated. Finger thoracostomy appears to be an acceptable and effective technique for trained physicians in the pre-hospital setting...
June 2017: Emergency Medicine Journal: EMJ
B A Leidel, K-G Kanz
For decades, survival rates of cardiac arrest following trauma were reported between 0 and 2 %. Since 2005, survival rates have increased with a wide range up to 39 % and good neurological recovery in every second person injured for unknown reasons. Especially in children, high survival rates with good neurologic outcomes are published. Resuscitation following traumatic cardiac arrest differs significantly from nontraumatic causes. Paramount is treatment of reversible causes, which include massive bleeding, hypoxia, tension pneumothorax, and pericardial tamponade...
November 2016: Medizinische Klinik, Intensivmedizin und Notfallmedizin
H Drinhaus, T Annecke, J Hinkelbein
Decompression of the chest is a life-saving invasive procedure for tension pneumothorax, trauma-associated cardiopulmonary resuscitation or massive haematopneumothorax that every emergency physician or intensivist must master. Particularly in the preclinical setting, indication must be restricted to urgent cases, but in these cases chest decompression must be executed without delay, even in subpar circumstances. The methods available are needle decompression or thoracentesis via mini-thoracotomy with or without insertion of a chest tube in the midclavicular line of the 2nd/3rd intercostal space (Monaldi-position) or in the anterior to mid-axillary line of the 4th/5th intercostal space (Bülau-position)...
October 2016: Der Anaesthesist
Kevin High, Jeremy Brywczynski, Oscar Guillamondegui
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...
July 2016: Air Medical Journal
James S Davis, George D Garcia, Jassin M Jouria, Mary M Wyckoff, Salman Alsafran, Jill M Graygo, Kelly F Withum, Carl I Schulman
OBJECTIVE: Chest tube thoracostomies are common surgical procedures, but little is known about how practitioners learn the skill. This study evaluates the frequency with which correctly performed tasks are executed by subjects during chest tube thoracostomies. DESIGN: In this prospective study, we developed a mobile-learning module, containing stepwise multimedia guidance on chest tube insertion. Next, we developed and tested a 14-item checklist, modeled after key skills in the module...
May 2013: Journal of Surgical Education
Y Nakajima
Open window thoracostomy for thoracic empyema: Open window thoracostomy is a simple, certain and final drainage procedure for thoracic empyema. It is most useful to drain purulent effusion from empyema space, especially for cases with broncho-pleural fistulas, and to clean up purulent necrotic debris on surface of empyema sac. For changing of packing gauzes in empyema space through a window once or twice every day after this procedure, thoracostomy will have to be made on the suitable position to empyema space...
July 2010: Kyobu Geka. the Japanese Journal of Thoracic Surgery
Eddie Kugju Song, F A Tony Mann, Colette C Wagner-Mann
OBJECTIVE: To compare Chinese finger trap (CFT) and 4 friction suture (FFS) techniques to secure gastrostomy (GT), jejunostomy (JT), and thoracostomy (TT) tubes of different materials. STUDY DESIGN: Prospective experimental study. ANIMALS: Canine cadavers (n=20). METHODS: Randomly, GT (n=20), JT (20), and TT (20) were inserted using 2 different suture techniques (10 for each tube type) and either silicone or another material (10 for each type)...
April 2008: Veterinary Surgery: VS
Sebastián E Vélez, Guillermo Sarquis
BACKGROUND: toracostomy in thoracic trauma is a good opportunity for the digital exploration of pleural cavity. OBJECTIVES: To evaluate the utility of digital exploration during chest tube insertion in thoracic trauma. SETTING: Hospital de Urgencias. Córdoba. PATIENTS AND METHODS: patients with blunt and penetrating chest trauma by stab wound, who need chest tube insertion and treated by only one surgeon, were evaluated from July 10 to December 31st 2000...
2006: Revista de la Facultad de Ciencias Médicas
Jiun Yoon, David R Finger, Joseph S Pina
We present an illustrative case of a patient with advanced scleroderma who presented with a spontaneous pneumothorax, a condition that has only rarely been reported previously in association with scleroderma. Our patient and those previously reported had advanced pulmonary fibrosis with honeycombing and subpleural cysts, with spontaneous pneumothorax occurring secondary to cyst rupture. Our patient was treated with chest tube thoracostomy, but her spontaneous pneumothorax later recurred. She was then treated with talc pleurodesis and has not had a recurrence in 18 months of follow-up...
August 2004: Journal of Clinical Rheumatology: Practical Reports on Rheumatic & Musculoskeletal Diseases
Olu Osinowo, Abdul-lateef L Softah, Mohammed Eid Zahrani
In the six-month period from October 1999 to March 2000, the authors carried out a prospective study of ectopic chest tube placements (ECTP) diagnosed at the Assir Central Hospital, Abha, Saudi Arabia. During the reference period, 63 chest tube placements were carried out in 44 patients while one patient was from a medium-sized general hospital within a neighbouring city. The grades of the surgeons who had performed the ECTP were: surgeon specialists based at peripheral hospitals--5 (83.3%), and surgical resident in training at the regional referral centre--1 (16...
March 2002: African Journal of Medicine and Medical Sciences
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