International Prehospital Medicine Institute Literature Review, January 2021

This study compares the 10-g AC to the 14-g AC for decompression of a tPTX and rescue from a tension-induced pulseless electrical activity (tPEA) in the setting of 30% estimated blood volume loss without hemothorax. The authors hypothesized the 10-g AC would be more effective and have a faster rescue from tension physiology than the 14-g AC currently used by most EMS systems. This was an animal study utilizing anesthetized pigs. The researchers placed arterial and venous lines for hemodynamic monitoring. They then placed 12-mm trocars through each diaphragm through which they could infuse carbon dioxide to simulate a tension pneumothorax. The pigs were bled to an estimated 30% blood volume loss to simulate hemorrhagic shock. Decompression devices were inserted at the second and third ICS MCL or the fifth and sixth ICS AAL on the side of the tension pneumothorax. The animals were allowed to recover for five minutes with their vital signs checked every minute. During this time, carbon dioxide insufflation was continued at a low rate to simulate a persistent air leak. The experiment was repeated up to four total times per animal. Similar methods were used to simulate the tPEA phase. tPEA was defined as a loss of the arterial waveform with the presence of cardiac activity. Successful recovery of an animal was defined as a return of mean arterial pressure to 20 mmHg and meaningful recovery was defined when SBP returned to 80% of the baseline value. Eighty tPTX and 50 tPEA ev...
Source: JEMS Special Topics - Category: Emergency Medicine Authors: Tags: Exclusives International Prehospital Medicine Institute Source Type: news