TY  - JOUR
PY  - 2020//
TI  - Finger thoracostomy in patients with chest trauma performed by paramedics on a helicopter emergency medical service
JO  - Emergency medicine Australasia
A1  - Bernard, Stephen
A1  - Kim, Yesul
A1  - Quinn, Nuala
A1  - Teague, Warwick
A1  - Judson, Rodney
A1  - Braitberg, George
A1  - Moloney, John
A1  - Olaussen, Alexander
A1  - Mitra, Biswadev
A1  - Fitzgerald, Mark
A1  - Smith, Karen
A1  - St Clair, Toby
A1  - Hannon, Liam
SP  - ePub
EP  - ePub
VL  - ePub
IS  - ePub
N2  - OBJECTIVE: To determine the frequency of finger thoracostomy performed by intensive care flight paramedics after the introduction of a training programme in this procedure and complications of the procedure that were diagnosed after hospital arrival.     METHODS: This was a retrospective cohort study of adult and paediatric trauma patients undergoing finger thoracostomy performed by paramedics on a helicopter emergency medical service between June 2015 and May 2018. Hospital data were obtained through a manual search of the medical records at each of the three receiving major trauma services. Additional data were sourced from the Victorian State Trauma Registry.     RESULTS: The final analysis included 103 cases, of which 73.8% underwent bilateral procedures with a total of 179 finger thoracostomies performed. The mean age of patients was 42.8 (standard deviation 21.4) years and 73.8% were male. Motor vehicle collision was the most common mechanism of injury accounting for 54.4% of cases. The median Injury Severity Score was 41 (interquartile range 29-54). There were 30 patients who died pre-hospital, with most (n = 25) having finger thoracostomy performed in the setting of a traumatic cardiac arrest. A supine chest X-ray was performed prior to intercostal catheter insertion in 38 of 73 patients arriving at hospital; of these, none demonstrated a tension pneumothorax. There were three cases of potential complications related to the finger thoracostomy.     CONCLUSION: Finger thoracostomy was frequently performed by intensive care flight paramedics. It was associated with a low rate of major complications and given the deficiencies of needle thoracostomy, should be the preferred approach for chest decompression.<p />  <p>Language: en</p>
LA  - en
SN  - 1742-6731
UR  - http://dx.doi.org/10.1111/1742-6723.13549
ID  - ref1
ER  -