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FINGER: A Novel Approach to Teaching Simple Thoracostomy
Andrew Merelman1, Natalie Zink2, Andrew D Fisher3
1Department of Emergency Medicine, University of New Mexico School of Medicine, Albuquerque, NM.
Air Medical Journal
|December 9, 2022
Summary
Prehospital clinicians can now use simple thoracostomy (finger thoracostomy) as a successful alternative to needle thoracostomy for tension pneumothorax. A new mnemonic, FINGER, aids in learning this life-saving procedure.
Area of Science:
- Emergency Medicine
- Surgical Procedures
- Prehospital Care
Background:
- Needle thoracostomy has historically been the primary prehospital treatment for tension pneumothorax but has a high failure rate.
- Simple thoracostomy (finger thoracostomy) is emerging as a more successful alternative, particularly following adoption by US military transport agencies.
Purpose of the Study:
- To address the challenges and intimidation associated with prehospital surgical procedures.
- To introduce a novel, memorable training strategy to improve clinician competence in simple thoracostomy.
Main Methods:
- Development and proposal of the FINGER mnemonic for learning simple thoracostomy.
- The mnemonic outlines key procedural steps: Find landmarks, Inject lidocaine, No infection, Generous incision, Enter pleural space, Reach in and reassess.
Main Results:
- The FINGER mnemonic is designed to reduce cognitive load during high-acuity, low-frequency events.
- This training aid aims to enhance learning and retention of the simple thoracostomy procedure.
Conclusions:
- Simple thoracostomy is a viable and effective treatment for tension pneumothorax and hemothorax in prehospital settings.
- The FINGER mnemonic offers a practical solution for training prehospital clinicians, improving procedural competence and patient outcomes.
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