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Needle thoracostomy in the prehospital setting
1Department of Emergency Medicine, University of Southern California School of Medicine, Los Angeles 90033, USA. eckstein@hsc.usc.edu
Prehospital Emergency Care
|August 26, 1998
Summary
Prehospital needle thoracostomy (NT) is rarely used by paramedics. While it carries risks, NT may benefit a small number of trauma patients with chest injuries.
Area of Science:
- Emergency Medicine
- Trauma Surgery
- Prehospital Care
Background:
- Needle thoracostomy (NT) is a life-saving procedure for tension pneumothorax.
- Its use in the prehospital setting by paramedics is less understood.
Purpose of the Study:
- To evaluate the frequency of prehospital NT use.
- To determine the effectiveness and complication rate of NT performed by paramedics.
Main Methods:
- Prospective case series conducted over two years at a Level I urban trauma center.
- Inclusion criteria: major trauma patients transported by paramedics who received prehospital NT.
Main Results:
- 1.7% of major trauma patients received NT (108/6241).
- Most common injuries: gunshot and stab wounds.
- Objective or subjective improvement noted in 12% of patients; 2% iatrogenic pneumothorax occurred.
Conclusions:
- Prehospital NT is infrequently performed by paramedics, even in high-trauma urban areas.
- While risks exist, NT may offer benefits to select patients with chest trauma.