Needle thoracocentesis in tension pneumothorax: Insufficient cannula length and potential failure

被引:71
作者
Britten, S
Palmer, SH
Snow, TM
机构
[1] Depts. Orthoped. Surg. and Radiol., Royal United Hospital, Bath
[2] Department of Orthopaedic Surgery, Royal United Hospital
来源
INJURY-INTERNATIONAL JOURNAL OF THE CARE OF THE INJURED | 1996年 / 27卷 / 05期
关键词
D O I
10.1016/0020-1383(96)00007-1
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Advanced Trauma Life Support guidelines recommend the use of a cannula 3 to 6 cm long to perform needle thoracocentesis for life-threatening tension pneumothorax. The chest wall thickness in the 2nd intercostal space, mid-clavicular line, was determined by ultrasound in 54 patients aged 18 to 55 years, and ranged from 1.3 to 5.2 cm (mean 3.2 cm). In thirty-one patients (57 per cent) the chest-wall thickness (CWT) was greater than 3 cm, the minimum recommended cannula length, although in only two (4 per cent) was it greater than 4.5 cm, the length of cannula commonly used in the UK. As a 3 cm cannula would fail to reach the pleural cavity in over half of patients, we suggest that the recommended shortest length be increased to 4.5 cm. Unsuccessful needle thoracocentesis using a 4.5 cm cannula should be followed immediately by insertion of a longer cannula or a definitive chest drain. (C) 1996 Elsevier Science Ltd.
引用
收藏
页码:321 / 322
页数:2
相关论文
共 3 条
[1]  
American College of Surgeons Committee on Trauma, 1993, ADV TRAUM LIF SUPP C
[2]   TREATMENT OF PNEUMOTHORACES UTILIZING SMALL CALIBER CHEST TUBES [J].
CONCES, DJ ;
TARVER, RD ;
GRAY, WC ;
PEARCY, EA .
CHEST, 1988, 94 (01) :55-57
[3]  
MINES D, 1993, ANN EMERG MED, V22, P133