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)

EMSAC 2024

EMSAC 2024

Contributors: Col. (Dr.) Stacy Shackelford Dr. Sean Keenan Paramedic Alan Moreland Dr. Chris Tems Kara Napolitano From military-inspired trauma protocols to behavioral health alternatives and cardiac ...

26 Jul 202511min

Episode 966: Acetaminophen Toxicity

Episode 966: Acetaminophen Toxicity

Contributor: Jorge Chalit-Hernandez, OMS4 Educational Pearls: What is the toxic dose of acetaminophen? 7.5 grams, in an adult. The safe daily limit is 4 grams in an adult with a normally functioning...

21 Jul 20253min

Episode 965: Oxygen Administration in Trauma Patients

Episode 965: Oxygen Administration in Trauma Patients

Contributor: Aaron Lessen, MD Educational Pearls: Many trauma patients are placed on oxygen via non-rebreather A large, multicenter, controlled trial evaluated the outcomes of oxygen administration i...

14 Jul 20252min

Episode 964: Ketamine & Midazolam for Prehospital Seizure Management

Episode 964: Ketamine & Midazolam for Prehospital Seizure Management

Contributor: Aaron Lessen, MD Educational Pearls: Prehospital seizures are typically managed with intramuscular midazolam (Versed) Seizures theoretically involve the NMDA pathway, and ketamine is a p...

7 Jul 20254min

Episode 963: Antihypertensives and Emergency Room Considerations

Episode 963: Antihypertensives and Emergency Room Considerations

Contributor: Alec Coston, MD Educational Pearls: For patients presenting to the emergency room with hypertension, clinicians should determine if it is isolated and uncomplicated, or involves comorbidi...

30 Jun 20254min

Episode 962: HEART Score

Episode 962: HEART Score

Contributor: Taylor Lynch, MD Educational Pearls: How do we risk-stratify chest-pain patients? One option is the HEART score This score predicts a patient's 6-week risk of a major adverse cardiac ev...

23 Jun 20254min

Episode 961: Cell Phone Sign

Episode 961: Cell Phone Sign

Contributor: Aaron Lessen, MD Educational Pearls: A prospective study at the Mayo Clinic Rochester was conducted to examine whether patients actively using their phones on initial assessment in the E...

16 Jun 20251min

Episode 960: Frank's Sign - A Marker for Coronary Artery Disease

Episode 960: Frank's Sign - A Marker for Coronary Artery Disease

Contributor: Travis Barlock MD Educational Pearls Frank's sign is a curious physical exam finding first described in the literature in 1973 Bilateral earlobe creases are recognized as a marker of co...

9 Jun 20251min

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