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This was the original:
http://www.resusme.em.extrememember...est-Drain-Insertion-in-Prehospital-Trauma.pdf
http://www.resusme.em.extrememember...est-Drain-Insertion-in-Prehospital-Trauma.pdf
In the context of the original question ("Is chest drain a suitable procedure to teach FPOS Medics?"), then I would strongly assert that simple thoracotomy is most definitely not a suitable alternative.
This procedure, when carried out by Emergency Doctors on HEMS or anywhere else, is only done so after the patient is anaesthetised, ET tubed and under positive pressure ventilation, and is therefore equally unsuitable for unqualified personnel.
This procedure, when carried out by Emergency Doctors on HEMS or anywhere else, is only done so after the patient is anaesthetised, ET tubed and under positive pressure ventilation, and is therefore equally unsuitable for unqualified personnel.
In the context of the original question ("Is chest drain a suitable procedure to teach FPOS Medics?"), then I would strongly assert that simple thoracotomy is most definitely not a suitable alternative.
This procedure, when carried out by Emergency Doctors on HEMS or anywhere else, is only done so after the patient is anaesthetised, ET tubed and under positive pressure ventilation, and is therefore equally unsuitable for unqualified personnel.
Agreed ;-) I would hope 'no thoracostomy' is being done on any conscious patient :-o
@xdmedical: I´ve done at leat 100 thoracostomies in local anaestethic. But I insert a chest drain in the proces.
Its extremely important that everybody reading the article above and decide to perform thoracostomy realize that this is only safe in INTUBATED patients being positive pressure ventilated. If not, all you´re doing is creating yet another possibility for a pressure pneumothorax, PTX.
Mike
MD, ER as i write
Its extremely important that everybody reading the article above and decide to perform thoracostomy realize that this is only safe in INTUBATED patients being positive pressure ventilated. If not, all you´re doing is creating yet another possibility for a pressure pneumothorax, PTX.
Mike
MD, ER as i write
kiwisteve85
New Member
hey Guys,
New to this,
high level and dangerous procedures are being taught to low level medical personal, such as combat lifesaver, combat first aiders in the form of drills. Some of these drills are effective if followed to the letter. An example of this is a needle chest decompression in the event of penertrating chest trauma, withn serious detiorating beathing in an isolated enviroment over time (this coud be done mid axullia, or mid clavicular) The reason this is an acceptable practice is simple, the person will die with no intervention. This could be preformed more than one time over a time period allowing time for skilled and experienced medical assistance to arrive. Is there a need to teach chest drains ? There is plenty of evidence to say even the skill and experienced opperator should withhold a drain in a stable patient. There are dangers in reducing or relesing the tamponade of blood, in the heamothorax/ tension pnumothorax patient. A complex issue. Experience is the name of the game, not just skill.
New to this,
high level and dangerous procedures are being taught to low level medical personal, such as combat lifesaver, combat first aiders in the form of drills. Some of these drills are effective if followed to the letter. An example of this is a needle chest decompression in the event of penertrating chest trauma, withn serious detiorating beathing in an isolated enviroment over time (this coud be done mid axullia, or mid clavicular) The reason this is an acceptable practice is simple, the person will die with no intervention. This could be preformed more than one time over a time period allowing time for skilled and experienced medical assistance to arrive. Is there a need to teach chest drains ? There is plenty of evidence to say even the skill and experienced opperator should withhold a drain in a stable patient. There are dangers in reducing or relesing the tamponade of blood, in the heamothorax/ tension pnumothorax patient. A complex issue. Experience is the name of the game, not just skill.
D
Deleted member 33
Guest
I'm pleased to see this thread has created a good level of response and concern.
Rich H
Rich H