Podcast 541: Needle Thoracostomy

Podcast 541: Needle Thoracostomy

Author: Aaron Lessen, MD

Educational Pearls:

  • Traditional technique of needle thoracostomy for tension penumothorax is along the 2nd intercostal space at the midclavicular line
  • Inserting a large angiocatheter along the 4th or 5th intercostal space at the mid-axillary line may provide a thinner area that is more easily identified, overcoming many of the obstacles of the traditional approach
  • The 10th Edition of ATLS now recommends this location as well
  • A finger thoracostomy, where a scalpel and then the finger are used to penetrate the pleural cavity at the same location, is another method to provide quick decompression of a traumatic tension pneumothorax, allowing a tube thoracostomy to be performed later

References

Laan DV, Vu TD, Thiels CA, et al. Chest wall thickness and decompression failure: A systematic review and meta-analysis comparing anatomic locations in needle thoracostomy. Injury. 2016;47(4):797–804. doi:10.1016/j.injury.2015.11.045

Inaba K, Branco BC, Eckstein M, Shatz DV, Martin MJ, Green DJ, Noguchi TT, Demetriades D. Optimal positioning for emergent needle thoracostomy: a cadaver-based study. J Trauma. 2011 Nov;71(5):1099-103; discussion 1103. doi: 10.1097/TA.0b013e31822d9618.

Summarized and edited by Erik Verzemnieks, MD



Jaksot(1146)

Podcast 754: Balanced Fluids vs. Normal Saline, The Battle Continues

Podcast 754: Balanced Fluids vs. Normal Saline, The Battle Continues

Contributor: Aaron Lessen, MD Educational Pearls: Normal saline is thought to interfere with renal function and cause an acidosis and balanced fluids (like lactated ringers) are a better option The S...

8 Helmi 20223min

Podcast 753: Ring Cutting Raptors

Podcast 753: Ring Cutting Raptors

Contributor: Aaron Lessen, MD Educational Pearls: Techniques regarding ring removal in the ED were evaluated in a recent study which looked at using trauma shears versus the motorized ring cutters A ...

7 Helmi 20222min

Podcast 752: Budesonide for COVID

Podcast 752: Budesonide for COVID

Contributor: Aaron Lessen, MD Educational Pearls: Recent study evaluated budesonide for outpatient COVID-19 infection treatment to see if there was a decrease in length of illness or hospitalization ...

1 Helmi 20222min

Podcast 751: The Bougie Trial

Podcast 751: The Bougie Trial

Contributor: Aaron Lessen, MD Educational Pearls: An endotracheal tube introducer or bougie are often used as a rescue device during difficult intubations as they are small and can be placed blindly ...

31 Tammi 20223min

Mental Health Monthly #9: Suicide Assessment in the ED: Using the ICAR2E Tool

Mental Health Monthly #9: Suicide Assessment in the ED: Using the ICAR2E Tool

Dr. Kim Nordstrom discusses a valuable bedside tool for evidence-based assessment in patients that visit the ED and are at risk for suicidality. Dr. Nordstrom is a practicing emergency psychiatrist an...

26 Tammi 20228min

Podcast 750: Take Home Naloxone

Podcast 750: Take Home Naloxone

Contributor: Aaron Lessen, MD Educational Pearls: Think about giving take home naloxone kits for anyone on long-term opioids as well as anyone with an opioid use disorder, those in opioid withdrawal,...

25 Tammi 20222min

Podcast 749: PCC for Me?

Podcast 749: PCC for Me?

Contributor: Nick Tsipis, MD Educational Pearls: Prothrombin complex concentrate (Kcentra)  and Vitamin K are used to reverse life-threatening bleeds in patients on warfarin (Coumadin) Factors II, VI...

24 Tammi 20224min

Podcast 748: Botulism

Podcast 748: Botulism

Contributor: Nick Hatch, MD Educational Pearls: Botulism requires a prompt clinical diagnosis as lab results can take about 5 days to return Whale blubber, honey, home fermented foods, homemade wine ...

18 Tammi 20228min

Suosittua kategoriassa Tiede

tiedekulma-podcast
rss-mita-tulisi-tietaa
rss-poliisin-mieli
docemilia
rss-duodecim-lehti
rss-luontopodi-samuel-glassar-tutkii-luonnon-ihmeita
utelias-mieli
rss-astetta-parempi-elama-podcast
filocast-filosofian-perusteet
rss-lapsuuden-rakentajat-podcast
rss-sosiopodi