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Needle thoracostomy may not be indicated in the trauma patient

D C Cullinane¹, J A Morris, J G Bass

¹Vanderbilt University Medical Center, Tennessee, Nashville, USA. cullinane.daniel@mayo.edu

|January 5, 2002

Abstract

Objective:

The aim of this study was to evaluate the usefulness of needle thoracostomy catheter (NTC) placement in trauma.

Methods:

A consecutive case series was conducted from November 1996 to September 1997. All patients admitted to a level I trauma centre who had NTCs placed prior to arrival in the Emergency Department were included. No patients were excluded or omitted. During the course of the study 2801 patients were admitted to our trauma centre. Nineteen patients (0.68%) had NTCs placed prior to arrival in the emergency department.

Results:

Twenty-five needle thoracostomies were performed in 19 patients. This group represented 0.68% of the trauma admissions. Four patients were found to have evidence of a pneumothorax with an air leak (28%). The NTC failed to decompress the chest in one of two patients who had physiologic evidence of a tension pneumothorax. Eleven patients (58%) were endotracheally intubated prior to NTC.

Conclusions:

This study suggests that field NTC placements are often ineffective and may be over-used. Further study on the usefulness of NTC is required.

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