Prehospital Needle Decompression Should Not Be Compared With Trauma Center Chest Tube Placement —Reply

In Reply We appreciate the interest of Jouffroy and Vivien in our study. Given the reported failure rates and complications of prehospital needle decompression (PHND), the value of the intervention has been questioned. Thus, we sought not to provide another detailed description in a case series but investigate in one of the largest populations undergoing PHND whether there is a potential outcome benefit to support further refinement and advancement of this technique. A major limitation has been the difficulty of diagnosing tension pneumothorax in the field and the empirical nature of PHND, leading to a lack of comparative studies to establish effectiveness. While we acknowledge the assumptions in our comparison group of emergency tube thoracostomy raised here, we believe given the above difficulties, this is a group that potentially would have benefited from earlier chest decompression in the field given the current landscape of US prehospital medicine.
Source: JAMA Surgery - Category: Sports Medicine Source Type: research