Prehospital needle thoracostomy: What are the indications and is a post-trauma center arrival chest tube required?

B. C. Axtman; K. E. Stewart; J. M. Robbins; T. Garwe; Z. Sarwar; R. A. Gonzalez; T. L. Zander; F. M. Balla; R. M. Albrecht

doi:10.1016/j.amjsurg.2019.09.020

Prehospital needle thoracostomy: What are the indications and is a post-trauma center arrival chest tube required?

B. C. Axtman, K. E. Stewart, J. M. Robbins, T. Garwe, Z. Sarwar, R. A. Gonzalez, T. L. Zander, F. M. Balla, R. M. Albrecht

Research output: Contribution to journal › Article › peer-review

1 Scopus citations

Abstract

Objective: This study examined the indications for prehospital needle thoracostomy (pNT), the need for tube thoracostomy (TT) following pNT, and the outcomes of patients who underwent pNT. Methods: This study is a retrospective chart review of patients who underwent pNT prior to trauma center arrival. Patients were identified from the trauma registry and a quality improvement (QI) database from 9/2014–9/2018. Results: 59 patients underwent 63 pNTs during the time period. The indication for pNT was “hypotension” in only 5 patients (7.9%). A CT chest was obtained on 51 NT attempts with the catheter in place. In 48 (94.1%) NT attempts, the catheter was not in the pleural space. 44 (69.4%) TTs were placed on admission date. Conclusion: In patients undergoing pNT, hypotension was rarely the indication. Additionally, CT identified the catheter within the pleural space in only 3 (5.8%) NT attempts. TT placement was performed in 79.3% of NT attempts.

Original language	English (US)
Pages (from-to)	1138-1142
Number of pages	5
Journal	American journal of surgery
Volume	218
Issue number	6
DOIs	https://doi.org/10.1016/j.amjsurg.2019.09.020
State	Published - Dec 2019
Externally published	Yes

ASJC Scopus subject areas

Surgery

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Prehospital needle thoracostomy : What are the indications and is a post-trauma center arrival chest tube required? / Axtman, B. C.; Stewart, K. E.; Robbins, J. M.; Garwe, T.; Sarwar, Z.; Gonzalez, R. A.; Zander, T. L.; Balla, F. M.; Albrecht, R. M.

In: American journal of surgery, Vol. 218, No. 6, 12.2019, p. 1138-1142.

Research output: Contribution to journal › Article › peer-review

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title = "Prehospital needle thoracostomy: What are the indications and is a post-trauma center arrival chest tube required?",

abstract = "Objective: This study examined the indications for prehospital needle thoracostomy (pNT), the need for tube thoracostomy (TT) following pNT, and the outcomes of patients who underwent pNT. Methods: This study is a retrospective chart review of patients who underwent pNT prior to trauma center arrival. Patients were identified from the trauma registry and a quality improvement (QI) database from 9/2014–9/2018. Results: 59 patients underwent 63 pNTs during the time period. The indication for pNT was “hypotension” in only 5 patients (7.9%). A CT chest was obtained on 51 NT attempts with the catheter in place. In 48 (94.1%) NT attempts, the catheter was not in the pleural space. 44 (69.4%) TTs were placed on admission date. Conclusion: In patients undergoing pNT, hypotension was rarely the indication. Additionally, CT identified the catheter within the pleural space in only 3 (5.8%) NT attempts. TT placement was performed in 79.3% of NT attempts.",

author = "Axtman, {B. C.} and Stewart, {K. E.} and Robbins, {J. M.} and T. Garwe and Z. Sarwar and Gonzalez, {R. A.} and Zander, {T. L.} and Balla, {F. M.} and Albrecht, {R. M.}",

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AU - Stewart, K. E.

AU - Robbins, J. M.

AU - Garwe, T.

AU - Sarwar, Z.

AU - Gonzalez, R. A.

AU - Zander, T. L.

AU - Balla, F. M.

AU - Albrecht, R. M.

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N2 - Objective: This study examined the indications for prehospital needle thoracostomy (pNT), the need for tube thoracostomy (TT) following pNT, and the outcomes of patients who underwent pNT. Methods: This study is a retrospective chart review of patients who underwent pNT prior to trauma center arrival. Patients were identified from the trauma registry and a quality improvement (QI) database from 9/2014–9/2018. Results: 59 patients underwent 63 pNTs during the time period. The indication for pNT was “hypotension” in only 5 patients (7.9%). A CT chest was obtained on 51 NT attempts with the catheter in place. In 48 (94.1%) NT attempts, the catheter was not in the pleural space. 44 (69.4%) TTs were placed on admission date. Conclusion: In patients undergoing pNT, hypotension was rarely the indication. Additionally, CT identified the catheter within the pleural space in only 3 (5.8%) NT attempts. TT placement was performed in 79.3% of NT attempts.

AB - Objective: This study examined the indications for prehospital needle thoracostomy (pNT), the need for tube thoracostomy (TT) following pNT, and the outcomes of patients who underwent pNT. Methods: This study is a retrospective chart review of patients who underwent pNT prior to trauma center arrival. Patients were identified from the trauma registry and a quality improvement (QI) database from 9/2014–9/2018. Results: 59 patients underwent 63 pNTs during the time period. The indication for pNT was “hypotension” in only 5 patients (7.9%). A CT chest was obtained on 51 NT attempts with the catheter in place. In 48 (94.1%) NT attempts, the catheter was not in the pleural space. 44 (69.4%) TTs were placed on admission date. Conclusion: In patients undergoing pNT, hypotension was rarely the indication. Additionally, CT identified the catheter within the pleural space in only 3 (5.8%) NT attempts. TT placement was performed in 79.3% of NT attempts.

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