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



Episoder(1145)

Episode 913: Vasopressors after ROSC

Episode 913: Vasopressors after ROSC

Contributor: Travis Barlock MD Educational Pearls: Recent study assessed outcomes after ROSC with epinephrine vs. norepinephrine Observational multicenter study from 2011-2018 285 patients rece...

23 Jul 20241min

Podcast 912: Narcan (Naloxone)

Podcast 912: Narcan (Naloxone)

Contributor: Taylor Lynch, MD Educational Pearls: Opioid Epidemic- quick facts Drug overdoses, primarily driven by opioids, have become the leading cause of accidental death in the U.S. for individu...

15 Jul 20246min

Episode 911: Anticholinergic Toxicity

Episode 911: Anticholinergic Toxicity

Contributor: Taylor Lynch MD Educational Pearls: Anticholinergics are found in many medications, including over-the-counter remedies Medications include: Diphenhydramine Tricyclic antidepressa...

8 Jul 20247min

Episode 910: Cellulitis Recovery Timeline

Episode 910: Cellulitis Recovery Timeline

Contributor: Aaron Lessen, MD Educational Pearls: How fast does cellulitis recover? A recent prospective cohort study took a look at this question. The study included 300 adults with cellulitis ...

2 Jul 20241min

Episode 909: Prehospital Blood Pressure Management in Suspected Stroke

Episode 909: Prehospital Blood Pressure Management in Suspected Stroke

Contributor: Aaron Lessen MD Educational Pearls: A recent study assessed EMS treatment of high blood pressure in the field 2404 patients randomized to prehospital treatment (1205) vs. usual care ...

24 Jun 20242min

Episode 908: Sympathomimetic Drugs

Episode 908: Sympathomimetic Drugs

Contributor: Taylor Lynch MD Educational Pearls: Overview: Sympathomimetic drugs mimic the fight or flight response, affecting monoamines such as dopamine, norepinephrine, and epinephrine Limited th...

17 Jun 20247min

Episode 907: Wide-Complex Tachycardia

Episode 907: Wide-Complex Tachycardia

Contributor: Travis Barlock MD Educational Pearls: Wide-complex tachycardia is defined as a heart rate > 100 BPM with a QRS width > 120 milliseconds Wide-complex tachycardia of supraventricular or...

12 Jun 20243min

Episode 906: Case Study of Hypernatremia

Episode 906: Case Study of Hypernatremia

Contributor: Aaron Lessen MD Educational Pearls: The case: A gentleman came in from a nursing home with symptoms concerning for sepsis. He was hypotensive, hypoxic, febrile, and mentally altered. ...

3 Jun 20243min

Populært innen Vitenskap

fastlegen
tingenes-tilstand
rekommandert
jss
rss-nysgjerrige-norge
rss-rekommandert
vett-og-vitenskap-med-gaute-einevoll
sinnsyn
forskningno
villmarksliv
nordnorsk-historie
fjellsportpodden
rss-paradigmepodden
smart-forklart
rss-overskuddsliv
aldring-og-helse-podden
diagnose
pod-britannia
tomprat-med-gunnar-tjomlid
tidlose-historier