![]() Traditionally, these are treated by inserting a large bore chest tube (LBCT). This new SGEM episode looks at the size of chest tubes needed to successfully treat a traumatic hemothorax. This observational study did not support the claim that the second intercostal space-midclavicular line is thicker than the fourth/fifth intercostal space-anterior axillary line. ![]() This was done with our good friend and frequent guest skeptic Dr. This randomized controlled trial demonstrated that conservative management was non-inferior to placing a chest tube in a patient with a large first-time spontaneous pneumothorax.Īnother SGEM episode we did looked at the location of needle decompression for tension pneumothorax ( SGEM#339). The other episode on chest tubes looked at conservative vs interventional treatment for spontaneous pneumothorax ( SGEM#300). The most important thing is placing the chest tube in the triangle of safety in the plural space ( SGEM#129). It turns out location (high or low) does not matter. The first time was looking at a study about where to put the chest tube in a trauma patient. This is usually with the master himself, Dr. CT scans reveal multiple right sided rib fractures and a hemothorax estimated to measure 500cc with no additional injuries.īackground: We have discussed chest tubes a couple of times on the SGEM. He is hemodynamically stable, oxygen saturation is 91% on room air, physical exam reveals ecchymosis and tenderness over the right chest wall with diminished right sided lung sounds. He did not seek medical attention at the time of the incident, but he has had persistent chest wall pain and worsening shortness of breath since yesterday evening. He reports he was riding his ATV along an embankment when it rolled, landing on top of him briefly. Prior to earning his MD, he worked as a paramedic in the New York City 911 system.Ĭase : A 43-year-old male presents to your emergency department (ED) the day after being involved in an all-terrain vehicle (ATV) accident. ![]() He is also a resident flight physician with UNM’s aeromedical service, UNM Lifeguard. Chris Root is a second-year resident physician in the Department of Emergency Medicine at the University of New Mexico Health Sciences Center in Albuquerque, NM. The small (14 Fr) percutaneous catheter (P-CAT) versus large (28–32 Fr) open chest tube for traumatic hemothorax: A multicenter randomized clinical trial.
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