The thoracostomy will prevent a tension pneumothorax, and should drain a
simple pneumothorax, but often leaves the blood behind (which lies
posteriorly in the supine patient). As a result you may have a sizeable
haemothorax which goes unnoticed until you drain it properly. In our unit
here in London, we receive neurotrauma from HEMS on a regular basis, but we
have no resident "chest cutters", so we have sometimes been embarassed to
get a bleeding chest in our department, which should really have gone
elsewhere! I'm sure Duncan or Tim could expand on this subject.
Adrian Fogarty
----- Original Message -----
From: <[log in to unmask]>
To: <[log in to unmask]>
Sent: Wednesday, May 01, 2002 3:46 PM
Subject: Chest drains - at all??
> How do people feel about using chest drains pre-hospital?
>
> In some places they just do a thoracostomy, make sure the hole is a decent
size
> and don't put the drain in until they reach hospital. I don't know if this
results
> in more complications such as the thoracostomy hole closing off en route,
haemmorhage
> from the wound site, infection etc but it certainly saves time and means
you
> have less equipment to worry about in a speeding, crowded ambulance.
>
> Ross Murphy
> SpR Edinburgh
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