Association between three prehospital thoracic decompression techniques by physicians and complications: a retrospective, multicentre study in adults.
Introduction: We sought to compare the complication rates of prehospital needle decompression, finger thoracostomy and three tube thoracostomy systems (Argyle, Frontline kits and endotracheal tubes) and to determine if finger thoracostomy is associated with shorter prehospital scene times compared w...
| Publicado en: | European Journal of Trauma & Emergency Surgery Vol. 49; no. 1; pp. 571 - 582 |
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| Autores principales: | , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Springer Nature
Feb2023
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=161854988&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 161854988 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 18639933 3C05 jtl: European Journal of Trauma & Emergency Surgery issn: 18639933 maglogo: N pubinfo: dt: Feb2023 vid: 49 iid: 1 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 161854988 158180449 161854988 161854988 10.1007/s00068-022-02049-z 161854988 ppf: 571 ppct: 11 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Association between three prehospital thoracic decompression techniques by physicians and complications: a retrospective, multicentre study in adults. aug: au: Garner, Alan Poynter, Elwyn Parsell, Ruth Weatherall, Andrew Morgan, Mary Lee, Anna affil: Nepean Clinical School, Trauma Services, Nepean Hospital, University of Sydney, Derby Street, 2747, Kingswood, NSW, Australia sug: subj: Thoracic Vertebrae Pathology Decompression, Surgical Methods Postoperative Complications Prevention and Control Prehospital Care Physicians Needles Utilization Thoracostomy Methods Retrospective Design Multicenter Studies Pneumothorax Relative Risk Confidence Intervals Tube Placement Determination Data Analysis Software Descriptive Statistics Human Male Young Adult Adult Middle Age Prospective Studies Thoracic Injuries Surgery Adult: 19-44 years Middle Aged: 45-64 years Male ab: Introduction: We sought to compare the complication rates of prehospital needle decompression, finger thoracostomy and three tube thoracostomy systems (Argyle, Frontline kits and endotracheal tubes) and to determine if finger thoracostomy is associated with shorter prehospital scene times compared with tube thoracostomy. Methods: In this retrospective cohort study we abstracted data on adult trauma patients transported by three helicopter emergency medical services to five Major Trauma Service hospitals who underwent a prehospital thoracic decompression procedure over a 75-month period. Comparisons of complication rates for needle, finger and tube thoracostomy and between tube techniques were conducted. Multivariate models were constructed to determine the relative risk of complications and length of scene time by decompression technique. Results: Two hundred and fifty-five patients underwent 383 decompression procedures. Fifty eight patients had one complication, and two patients had two complications. There was a weak association between decompression technique (finger vs tube) and adjusted risk of overall complication (RR 0.58, 95% CI: 0.33–1.03, P = 0.061). Recurrent tension physiology was more frequent in finger compared with tube thoracostomy (13.9 vs 3.2%, P < 0.001). Adjusted prolonged (80th percentile) scene time was not significantly shorter in patients undergoing finger vs tube thoracostomy (56 vs 63 min, P = 0.197), nor was the infection rate lower (2.7 vs 2.1%, P = 0.85). Conclusions: There was no clear evidence for benefit associated with finger thoracostomy in reducing overall complication rates, infection rates or scene times, but the rate of recurrent tension physiology was significantly higher. Therefore, tube placement is recommended as soon as practicable after thoracic decompression. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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