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Updated: Jul 17, 2026
05:39
Non-Intubated Video-Assisted Thoracoscopic Surgery
Published on: May 26, 2023
Trauma Video Review: Tube Thoracostomy Placement in Hemodynamically Stable versus Unstable Patients
Jaclyn A VanDerWal1, Anna Tatakis1, Danielle J Wilson1
1Division of Trauma, Critical Care and Acute Care Surgery, Department of Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin.
The Journal of Surgical Research
|July 15, 2026
Summary
Trauma teams place tube thoracostomy (TT) more efficiently in hemodynamically unstable patients. While sterile technique compliance was low, antibiotic administration was generally appropriate, highlighting areas for quality improvement in trauma resuscitation.
Area of Science:
- Trauma Surgery
- Emergency Medicine
- Procedural Quality Improvement
Background:
- Tube thoracostomy (TT) is a critical trauma resuscitation procedure.
- Hemodynamic status's impact on TT timing and technique is poorly understood.
- Trauma Video Review (TVR) offers objective procedural analysis.
Purpose of the Study:
- To investigate the effect of patient hemodynamics on TT placement efficiency and technique.
- To compare TT procedural metrics between hemodynamically stable and unstable trauma patients.
Main Methods:
- Single-center observational study analyzing audiovisual recordings of TT placements.
- Patient data included demographics, hemodynamics, TT indication, and procedural steps.
- Hemodynamically unstable (HDU) patients defined by SBP < 90, HR > 120, or RR > 24.
Main Results:
- Thirty-one TT placements in 28 patients were analyzed.
- No significant differences in individual procedural component timing between stable and unstable groups.
- Total procedural time was significantly shorter in hemodynamically unstable patients (P=0.02).
- Low compliance with sterile technique observed in both groups (2/31 procedures).
Conclusions:
- Trauma teams perform TT more efficiently in hemodynamically unstable patients.
- Sterile technique compliance is a key area for quality improvement initiatives.
- Antibiotic administration was generally adequate despite procedural variations.
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