Devices Used in the Treatment of Tension Pneumothorax

AbstractPurpose of ReviewThis review will describe pathophysiology, current emergency department (ED) treatment strategies, and novel devices used in the management of acute tension pneumothorax.Recent FindingsTraditional decompression success rates for the treatment of acute tension pneumothorax utilizing a standard 5-cm angiocatheter are inadequate in many cases. Novel devices and anatomical approaches have recently been developed to improve upon the rate of successful decompression and treatment.SummaryRecent studies have shown greater success in emergent decompression of acute tension pneumothorax at the 4th or 5th intercostal space along the anterior axillary line, when compared to the traditional decompression site at the 2nd or 3rd intercostal space at the mid clavicular line. The standard 5-cm catheter used for decompression may not be long enough in many patients to reach the intrapleural space at the 2nd intercostal space along the mid clavicular line. The use of an 8-cm angiocatheter may be required at the 4th or 5th intercostal insertion site at the anterior axillary line. Novel decompression devices have been studied in animal models with improved success rates and quicker time to restoration of normal physiology. Devices described in this review include the modified Veress needle and the Reactor ™ device. Human clinical trials are needed to confirm the safety and efficacy of these devices for clinical use.
Source: Current Emergency and Hospital Medicine Reports - Category: Emergency Medicine Source Type: research