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Pneumothorax needle decompression

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https://www.readbyqxmd.com/read/28885469/bigger-is-better-comparison-of-alternative-devices-for-tension-hemopneumothorax-and-pulseless-electrical-activity-in-a-yorkshire-swine-model
#1
Matthew L Leatherman, Laura M Fluke, Christian S McEvoy, Douglas M Pokorny, Robert L Ricca, Matthew J Martin, Christopher S Gamble, Travis M Polk
BACKGROUND: Tension pneumothorax is a cause of potentially preventable death in prehospital and battlefield settings and 14-gauge angiocatheter (14G AC) decompression remains the current treatment standard, despite its high incidence of failure. Traumatic pneumothorax is often associated with hemothorax, but 14G AC has no proven efficacy for associated hemothorax. We sought to compare the 14G AC to three alternative devices for treatment of tension hemopneumothorax (t-H/PTX) in a positive-pressure ventilation swine model...
December 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28780253/biomechanics-of-human-parietal-pleura-in-uniaxial-extension
#2
Luis E Morales Tenorio, Kelsey J Devine, Jayme Lee, Timothy M Kowalewski, Victor H Barocas
Tension pneumothorax, a major preventable cause of battlefield death, often arises from chest trauma and is treated by needle decompression to release trapped air from the pleural cavity. Surgical simulation mannequins are often employed to train medical personnel to perform this procedure properly. Accurate reproduction of the mechanical behavior of the parietal pleura, especially in response to needle penetration, is essential to maximize the fidelity of these surgical simulators. To date, however, the design of pleura-simulating material has been largely empirical and based on subjective practitioner feel rather than on the tissue properties, which have remained unknown...
July 29, 2017: Journal of the Mechanical Behavior of Biomedical Materials
https://www.readbyqxmd.com/read/28602180/evaluation-of-monaldi-s-approach-with-regard-to-needle-decompression-of-the-tension-pneumothorax-a-cadaver-study
#3
G M Hohenberger, A Schwarz, F Hohenberger, T Niernberger, R Krassnig, N Hörlesberger, A H Weiglein, V Matzi
BACKGROUND: Although needle decompression of tension pneumothorax through the second intercostal space in the midclavicular line (Monaldi's approach) is a life-saving procedure, severe complications have been reported after its implementation. We evaluated the procedure by comparing how it was performed on cadavers by study participants with different training levels. METHODS: Six participants including one thoracic surgeon performed bilateral thoracic drainage after Monaldi on 82 torsos...
September 2017: Injury
https://www.readbyqxmd.com/read/28499514/needle-decompression-of-tension-pneumothorax-with-colorimetric-capnography
#4
Nimesh D Naik, Matthew C Hernandez, Jeff R Anderson, Erika K Ross, Martin D Zielinski, Johnathon M Aho
BACKGROUND: The success of needle decompression for tension pneumothorax is variable, and there are no objective measures assessing effective decompression. Colorimetric capnography, which detects carbon dioxide present within the pleural space, may serve as a simple test to assess effective needle decompression. METHODS: Three swine underwent traumatically induced tension pneumothorax (standard of care, n = 15; standard of care with needle capnography, n = 15)...
May 10, 2017: Chest
https://www.readbyqxmd.com/read/28458928/iatrogenic-right-sided-pneumothorax-presenting-as-st-segment-elevation-a-rare-case-report-and-review-of-literature
#5
Bashar Alzghoul, Ayoub Innabi, Anusha Shanbhag, Kshitij Chatterjee, Farah Amer, Nikihil Meena
Pneumothorax is a well-recognized complication of central venous line insertion (CVL). Rarely, pneumothorax can lead to electrocardiogram (ECG) findings mimicking ST-segment elevation myocardial infarction. We present a 63-year-old man with iatrogenic right-sided pneumothorax who developed ST-segment elevation on a 12-lead ECG suggestive of myocardial infarction. The ECG findings completely resolved after needle decompression and chest tube placement. This case points up this rare electrocardiographic finding with discussion of possible mechanisms and differential diagnosis...
2017: Case Reports in Critical Care
https://www.readbyqxmd.com/read/28383466/relative-device-stability-of-anterior-versus-axillary-needle-decompression-for-tension-pneumothorax-during-casualty-movement-preliminary-analysis-of-a-human-cadaver-model
#6
Matthew L Leatherman, Jenny M Held, Laura M Fluke, Christian S McEvoy, Kenji Inaba, Daniel Grabo, Matthew J Martin, Angela S Earley, Robert L Ricca, Travis M Polk
BACKGROUND: Tension pneumothorax (tPTX) remains a significant cause of potentially preventable death in military and civilian settings. The current prehospital standard of care for tPTX is immediate decompression with a 14-gauge 8-cm angiocatheter; however, failure rates may be as high as 17% to 60%. Alternative devices, such as 10-gauge angiocatheter, modified Veress needle, and laparoscopic trocar, have shown to be potentially more effective in animal models; however, little is known about the relative insertional safety or mechanical stability during casualty movement...
July 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28116675/anesthetic-considerations-for-patients-with-esophageal-achalasia-undergoing-peroral-endoscopic-myotomy-a-retrospective-case-series-review
#7
Benjamin Löser, Yuki B Werner, Mark A Punke, Bernd Saugel, Sebastian Haas, Daniel A Reuter, Oliver Mann, Anna Duprée, Guido Schachschal, Thomas Rösch, Martin Petzoldt
PURPOSE: Peroral endoscopic myotomy (POEM) is a novel technique for treating esophageal achalasia. During POEM, carbon dioxide (CO2) is insufflated to aid surgical dissection, but it may inadvertently track into surrounding tissues, causing systemic CO2 uptake and tension capnoperitoneum. This in turn may affect cardiorespiratory function. This study quantified these cardiorespiratory effects and treatment by hyperventilation and percutaneous abdominal needle decompression (PND). METHODS: One hundred and seventy-three consecutive patients who underwent POEM were included in this four-year retrospective study...
May 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/27939518/failure-rate-of-prehospital-chest-decompression-after-severe-thoracic-trauma
#8
COMPARATIVE STUDY
Alexander Kaserer, Philipp Stein, Hans-Peter Simmen, Donat R Spahn, Valentin Neuhaus
INTRODUCTION: Chest decompression can be performed by different techniques, like needle thoracocentesis (NT), lateral thoracostomy (LT), or tube thoracostomy (TT). The aim of this study was to report the incidence of prehospital chest decompression and to analyse the effectiveness of these techniques. MATERIAL AND METHODS: In this retrospective case series study, all medical records of adult trauma patients undergoing prehospital chest decompression and admitted to the resuscitation area of a level-1 trauma center between 2009 and 2015 were reviewed and analysed...
March 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27629501/-chest-decompression-in-emergency-medicine-and-intensive-care
#9
REVIEW
H Drinhaus, T Annecke, J Hinkelbein
Decompression of the chest is a life-saving invasive procedure for tension pneumothorax, trauma-associated cardiopulmonary resuscitation or massive haematopneumothorax that every emergency physician or intensivist must master. Particularly in the preclinical setting, indication must be restricted to urgent cases, but in these cases chest decompression must be executed without delay, even in subpar circumstances. The methods available are needle decompression or thoracentesis via mini-thoracotomy with or without insertion of a chest tube in the midclavicular line of the 2nd/3rd intercostal space (Monaldi-position) or in the anterior to mid-axillary line of the 4th/5th intercostal space (Bülau-position)...
October 2016: Der Anaesthesist
https://www.readbyqxmd.com/read/27563467/trauma-simulation-training-increases-confidence-levels-in-prehospital-personnel-performing-life-saving-interventions-in-trauma-patients
#10
Christine M Van Dillen, Matthew R Tice, Archita D Patel, David A Meurer, Joseph A Tyndall, Marie Carmelle Elie, Jonathan J Shuster
Introduction. Limited evidence is available on simulation training of prehospital care providers, specifically the use of tourniquets and needle decompression. This study focused on whether the confidence level of prehospital personnel performing these skills improved through simulation training. Methods. Prehospital personnel from Alachua County Fire Rescue were enrolled in the study over a 2- to 3-week period based on their availability. Two scenarios were presented to them: a motorcycle crash resulting in a leg amputation requiring a tourniquet and an intoxicated patient with a stab wound, who experienced tension pneumothorax requiring needle decompression...
2016: Emergency Medicine International
https://www.readbyqxmd.com/read/27154984/cardiac-arrest-due-to-a-missed-diagnosis-of-boerhaave-s-syndrome
#11
Jennifer Davies, David Spitzer, Maria Phylactou, Martin Glasser
A 91-year-old presented with a rare cause of cardiac arrest. He was initially admitted with severe back pain following vomiting and diagnosed with probable aspiration pneumonia. On day 3 of admission, he was discovered in cardiac arrest and cardiopulmonary resuscitation was started. On intubation, a left-sided pneumothorax and subcutaneous emphysema were noted. Needle decompression showed gastric fluid leaking from the cannula. The patient regained a cardiac output, and a subsequent CT scan confirmed a large pneumomediastinum with air tracking to the neck and chest, and bilateral pneumothoraces...
May 6, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/26683398/needle-decompression-of-tension-pneumothorax-population-based-epidemiologic-approach-to-adequate-needle-length-in-healthy-volunteers-in-northeast-germany
#12
Matthias Hecker, Katrin Hegenscheid, Henry Völzke, Peter Hinz, Jörn Lange, Axel Ekkernkamp, Matthias Frank
BACKGROUND: Tension pneumothorax is one of the leading causes of preventable death in both military and civilian trauma patients. Needle decompression is recommended in trauma guidelines as an emergency procedure to relieve increased intrapleural pressure. The main reason for decompression failure is reported to be insufficient needle length in proportion to the chest wall thickness (CWT). So far, population-based epidemiologic data on CWT are missing. Therefore, it was the aim of this work to investigate the CWT in the second intercostal space, midclavicular line, based on magnetic resonance imaging data of a large population-based sample...
January 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/26535176/nontuberculous-mycobacterial-infection-presenting-as-empyema-and-life-threatening-pneumothorax-a-challenging-situation-in-the-emergency-department
#13
Shahzad Anjum, Ramsha Tahir, Sameer A Pathan
Nontuberculous mycobacterial infection in an immunocompetent young patient complicated with empyema and pneumothorax is rarely reported. A 36-year-old man presented to the emergency department with a history of worsening dyspnea and pleuritic chest pain. The patient had unstable vital signs on presentation, and was referred to the resuscitation area on a monitored bed. The patient had a chest x-ray (CXR) performed on a prior occasion at a primary health clinic, revealing pneumothorax and some fluid at the left costophrenic angle...
2015: Qatar Medical Journal
https://www.readbyqxmd.com/read/26488319/cadaveric-comparison-of-the-optimal-site-for-needle-decompression-of-tension-pneumothorax-by-prehospital-care-providers
#14
COMPARATIVE STUDY
Kenji Inaba, Efstathios Karamanos, Dimitra Skiada, Daniel Grabo, Peter Hammer, Matthew Martin, Maura Sullivan, Marc Eckstein, Demetrios Demetriades
BACKGROUND: Computed tomographic and cadaveric studies have demonstrated needle decompression of tension pneumothorax at the fifth intercostal space (ICS), anterior axillary line (AAL) has advantages over the second ICS midclavicular line (MCL). The purpose of this study was to compare the ability of prehospital care providers to accurately decompress the chest at these two locations. METHODS: Randomly selected US Navy hospital corpsmen (n = 25) underwent a standardized training session followed by timed needle decompression on unmarked fresh cadavers...
December 2015: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/26360355/what-is-the-optimal-device-length-and-insertion-site-for-needle-thoracostomy-in-uk-military-casualties-a-computed-tomography-study
#15
Georgina Blenkinsop, Somayyeh Mossadegh, Mark Ballard, Paul Parker
Significant lessons to inform best practice in trauma care should be learned from the last decade of conflict in Afghanistan and Iraq. This study used radiological data collated in the UK Military Hospital in Camp Bastion, Afghanistan, to investigate the most appropriate device length for needle chest decompression of tension pneumothorax (TP). We reviewed the optimal length of device and site needed for needle decompression of a tension pneumothorax in a UK military population and found no significant difference between sites for needle chest decompression (NCD)...
2015: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
https://www.readbyqxmd.com/read/26206480/an-infant-with-a-hyperlucent-chest-mass-an-unexpected-diagnosis
#16
Zarmina Ehsan, Jaimie D Nathan, Carolyn M Kercsmar
INTRODUCTION: We report an unusual finding of pneumatocele in an infant. CASE REPORT: A previously well four month old presented with worsening respiratory distress over 6 weeks. He had no antecedent signs or symptoms of respiratory infection. Chest radiograph demonstrated a lucent hemithorax concerning for tension pneumothorax. Urgent needle decompression was performed. Chest CT showed a persistent dominant macrocyst on the left. Thoracotomy revealed a large cystic lesion necessitating a left lower lobectomy...
December 2015: Pediatric Pulmonology
https://www.readbyqxmd.com/read/26100771/needle-thoracostomy-for-tension-pneumothorax-the-israeli-defense-forces-experience
#17
Jacob Chen, Roy Nadler, Dagan Schwartz, Homer Tien, Andrew P Cap, Elon Glassberg
BACKGROUND: Point of injury needle thoracostomy (NT) for tension pneumothorax is potentially lifesaving. Recent data raised concerns regarding the efficacy of conventional NT devices. Owing to these considerations, the Israeli Defense Forces Medical Corps (IDF-MC) recently introduced a longer, wider, more durable catheter for the performance of rapid chest decompression. The present series represents the IDF-MC experience with chest decompression by NT. METHODS: We reviewed the IDF trauma registry from January 1997 to October 2012 to identify all cases in which NT was attempted...
June 2015: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/26038022/traumatic-tension-pneumothorax-experience-from-115-consecutive-patients-in-a-trauma-service-in-south-africa
#18
V Kong, B Sartorius, D Clarke
INTRODUCTION: Traumatic tension pneumothorax (TPTX) is a life threatening condition, but literature describing this condition specifically in developing countries is scarce. MATERIALS AND METHODS: We conducted a retrospective review of 115 patients with a TPTX, managed over a 4-year period in a high volume trauma service in South Africa. RESULTS: A total of 118 TPTXs were identified in 115 patients. Eighty-nine percent (102/115) were males, and the mean age was 26 years (SD ± 6 years)...
February 2016: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/25900313/failed-needle-decompression-of-bilateral-spontaneous-tension-pneumothorax
#19
P T Bach, C Sølling
This case report presents a young male admitted with primary bilateral spontaneous tension pneumothorax and severe respiratory distress. This is an extremely rare condition. The patient was on the verge of hypoxic cardiac arrest and the attempted needle thoracocentesis was unsuccessful. Needle thoracocentesis in the midclavicular line of the second intercostal space is widely used and recommended as first-line treatment of tension pneumothorax. Reviewing the literature, the procedure is not based on solid evidence...
July 2015: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/25857267/sufficient-catheter-length-for-pneumothorax-needle-decompression-a-meta-analysis
#20
Brian M Clemency, Christopher T Tanski, Michael Rosenberg, Paul R May, Joseph D Consiglio, Heather A Lindstrom
INTRODUCTION: Needle thoracostomy is the prehospital treatment for tension pneumothorax. Sufficient catheter length is necessary for procedural success. The authors of this study determined minimum catheter length needed for procedural success on a percentile basis. METHODS: A meta-analysis of existing studies was conducted. A Medline search was performed using the search terms: needle decompression, needle thoracentesis, chest decompression, pneumothorax decompression, needle thoracostomy, and tension pneumothorax...
June 2015: Prehospital and Disaster Medicine
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