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)

Carepoint Journal Club: Trauma Discussion

Carepoint Journal Club: Trauma Discussion

Carepoint Journal Club is a quarterly series with discussions about a medical topic, brought to you by Carepoint's Emergency Physicians.

22 Des 202545min

Episode 987: Cough Suppressants

Episode 987: Cough Suppressants

Contributor: Meghan Hurley, MD Educational Pearls:  OTC Medications Dextromethorphan (DM) Most common OTC cough suppressant Minimal efficacy: Little evidence that it shortens the duration or severit...

15 Des 20257min

Episode 986: Lateral Canthotomy in Emergency Settings

Episode 986: Lateral Canthotomy in Emergency Settings

Contributor: Taylor Lynch, MD Educational Pearls: What is orbital compartment syndrome, and how is it assessed in the emergency room? Orbital compartment syndrome (OCS) is an emergent ophthalmic cond...

8 Des 20254min

Episode 985: Amiodarone vs. Lidocaine

Episode 985: Amiodarone vs. Lidocaine

Contributor: Aaron Lessen, MD Educational Pearls: How do amiodarone and lidocaine work on the heart? Amiodarone Blocks potassium channels (Class III effect). Also blocks sodium and calcium channels....

8 Des 20252min

Episode 984: Fish Hooks

Episode 984: Fish Hooks

Contributor: Megan Hurley, MD Educational Pearls: Assess first: confirm the hook isn't near vital structures. Automatic subspecialty consult for eye involvement or proximity to carotid artery, radial...

24 Nov 20254min

Episode 983: Head-of-Bed Position in Large Vessel Occlusion Strokes

Episode 983: Head-of-Bed Position in Large Vessel Occlusion Strokes

Contributor: Aaron Lessen MD Educational Pearls:  Recent prospective randomized clinical trial assessed optimal head-of-bed positioning in patients with LVO 0º vs. 30º elevation Objective was to det...

18 Nov 20252min

Episode 982: Epistaxis Management

Episode 982: Epistaxis Management

Contributor: Meghan Hurley, MD Educational Pearls: 1. Initial Assessment Start with a physical examination: Determine if the bleed is anterior or posterior. Perform a primary survey: assess ai...

10 Nov 20256min

Episode 981: Electrical Burns

Episode 981: Electrical Burns

Contributor: Travis Barlock, MD Educational Pearls: Quick Statistics on Electrical Burns: Electrical burns compose roughly 2 to 9% of all burns that come into emergency departments. The majority of p...

3 Nov 20253min

Populært innen Vitenskap

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