OBJECTIVE: Recent literature suggests that @entity1 who undergo emergent tube thoracostomy in the field are at increased risks for complications. This study evaluates indications, complications, and effectiveness of field placement of chest tubes by an aeromedical service. METHODS: In a prospective study, 624 consecutive @entity1 with @entity764 (Abbreviated Injury Scale score 1-6) were included. All @entity1 were treated at the scene by a physician-staffed aeromedical service and transported by air to a Level I @entity130 center. Indications, clinical findings before and after chest tube insertion, and subsequent radiologic diagnosis by chest roentgenography were documented prospectively. RESULTS: Seventy-six chest tubes (50 unilateral, 13 bilateral) were inserted laterally in 63 @entity1 (10%) by blunt dissection. Clinical findings included pneumothorax in 30 @entity1 and hemothorax in 18 @entity1 . In 15 @entity1 receiving field chest tubes, neither pneumothorax nor hemothorax was confirmed. Six @entity1 (<1%) arrived at the @entity130 center with unsuspected pneumothoraces and required chest tube insertion. No tension pneumothoraces escaped field detection and treatment. Four chest tubes placed in the field required repositioning in the hospital because of malfunction or malpositioning. Radiologic findings excluded intraparenchymal tube placements in all @entity1 . No @entity281 were observed in these 63 @entity1 during their hospital stay. No antibiotics were administered as a result of prehospital chest tube placement. CONCLUSION: Prehospital chest tube thoracostomy is safe, effective, and associated with low morbidity. Nontherapeutic chest tube placements occurred in 15 of 624 @entity1 (2.4%); missed pneumothoraces occurred in 6 of 624 @entity1 (<1%). Aggressive prehospital physician management of blunt @entity764 leads to an earlier treatment of potentially life-threatening injuries. Significant morbidity can be avoided by prompt pleural decompression using proper techniques.

Chest tube decompression of blunt XXXX by physicians in the field: effectiveness and complications.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity281 :: ('MESH:D007239', 'Disease') :: ['pleural infections'] @entity764 :: ('MESH:D013898', 'Disease') :: ['chest injuries', 'chest trauma'] @entity130 :: ('MESH:D014947', 'Disease') :: ['trauma']
@entity764 :: (MESH:D013898,Disease) :: ['chest injuries']
