Trocar during Times of Trauma

​Seventy-five percent of trauma injuries involve some kind of thoracic insult, a quarter of which need a procedural intervention like a chest tube. (Surg Clin North Am 2007;87[1]:95; http://bit.ly/2HaoX90.) Long-term illness, lung disease, and post-operative complications may cause pleural effusions or a pneumothorax, so treating these conditions quickly can significantly decrease patient morbidity and mortality. Other indications for chest tube placement include:Trauma: Pneumothorax, hemopneumothorax, or tension pneumothoraxLong-term illness: Pleural effusion (cancer, pneumonia)Infection: Empyema, purulent pleuritisPost-surgery, especially after lung, heart, or esophageal surgeryBronchoscopyA CT showing a chest tube in the right lung and pneumothorax in the left lung from trauma. Scan courtesy of Clinical Cases.Inserting a chest tube is literally hit or miss. If you miss, you may seriously compromise the outcome, so you need to embrace a few simple concepts: know your landmarks, know your technique and tools, and know the cautions and what can go wrong.This 49-year-old morbidly obese woman had a spontaneous pneumothorax four days after elective bronchoscopy. Note the misplaced pigtail catheter in the subcutaneous tissue to the left of the fifth intercostal space on the right side of the patient's rib cage. The standard approach was used for this insertion without success.The BasicsChest tube insertion should be well-rehearsed and instinctiv...
Source: The Procedural Pause - Category: Emergency Medicine Tags: Blog Posts Source Type: blogs