> Another best bet where 300 papers are identified, 298 disregarded due to
> being inconclusive. The other 2 too flawed to be conclusive. Clinical
bottom
> line follow local policy ie. we havent achieved anything from our three
part
> question
> Andy Webster
AW clearly not a convert then!!! For the record I have NO intention of
Betting this topic (I am pretty certain there is no data out there - the
Cook rep did not know of any - but I have not looked).
Anyway, I have attached a message from a CT surgeon (via Pete Driscoll)
which may inform the debate.
Simon
Simon Carley
SpR in Emergency Medicine
[log in to unmask]
Evidence based emergency medicine
http://www.bestbets.org
A quick reply from a very experienced cardio-thoracic surgeon.
Pete
-----Original Message-----
From: Hyde, Jonathan [mailto:[log in to unmask]]
Sent: Tuesday, April 30, 2002 4:53 PM
To: 'Driscoll Peter'
Subject: RE: chest drains - how big??
For air, any size is fine as the whole drainage issue is a simple matter of
physics. It doesn't even have to be apical, although it will possibly make
things better. The issue of apical and basal drains is an urban myth, since
a correctly inserted and sealed drain applied to suction will cause
expansion of the lung with subsequent expulsion of the pleural contents
through the only exit possible (i.e the drain), wherever that might be.
My own experience, with no scientific backing (but many years of inserting
chest drains for thoracic blood in routine cardiac surgery cases), is that
drains do block with blood, and even though we use 32F drains as standard
for cardiac surgery, some of those even block with clots.
My practice, therefore, is to use nothing smaller than a 28F for trauma.
Hope this is of help.
Jonathan
----------
From: Driscoll Peter [SMTP:[log in to unmask]]
Sent: 30 April 2002 16:09
To: Jonathan Hyde (E-mail)
Cc: Simon Carley (E-mail)
Subject: FW: chest drains - how big??
Jonathan
Can you help out with this question?
Pete
-----Original Message-----
From: [log in to unmask] [mailto:[log in to unmask]]
Sent: Tuesday, April 30, 2002 1:57 PM
To: [log in to unmask]; [log in to unmask];
[log in to unmask]; [log in to unmask];
[log in to unmask]; [log in to unmask];
[log in to unmask];
[log in to unmask]
Subject: Fwd: chest drains - how big??
Interesting question! - any answers? any science to back it up?
regards
John
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