Fair point and definately worth mentioning. Most of the papers contain mixed
patient groups. There was a proposal to do a PRCT of this type of thing in
non-penetrating trauma but I don't think it got off the ground. I have
updated the comments section of the BET accordingly.
Personlly, I would expect the incidence of infective complications to be
gunshot>stab>blunt>nontrauma>spontaneous. But that is just my thoughts
rather than anything based on evidence/experience. My impression is that the
event rate for infection in non penetrating and spontaneous PNX is low so a
big study would be required.
There is an evidence based review on the EAST site as well looking at this
topic http://www.east.org/tpg/chesttube.pdf
which comes up with many of the concerns already expressed.
The EAST site does some pretty impressive stuff and is worth a look for some
of their other practice guidelines. They are in the style of the Cochrane
reviews. http://www.east.org
Simon
Simon Carley
SpR in Emergency Medicine
Manchester Royal Infirmary
England
[log in to unmask]
Evidence based Emergency Medicine
http://www.bestbets.org
----- Original Message -----
From: Ray McGlone <[log in to unmask]>
To: <[log in to unmask]>
Sent: Sunday, April 22, 2001 2:01 PM
Subject: Re: antibiotics in chest trauma + drain
> Many of these papers (if not all) included penetrating chest trauma in the
> figures. I certainly would give prophylactic antibiotics for patients
> presenting with penetrating chest trauma, but I'm not sure about the
> efficacy in blunt trauma prior to inserting a chest drain?
>
> Ray McGlone
> A&E Lancaster
>
> ----- Original Message -----
> From: "Simon Carley" <[log in to unmask]>
> To: <[log in to unmask]>
> Sent: Sunday, April 22, 2001 8:38 AM
> Subject: Re: antibiotics in chest trauma + drain
>
>
> > Yes - in trauma
> > See:- http://www.bestbets.org/cgi-bin/bets.pl?record=00121
> > Simon Carley
> > SpR in Emergency Medicine
> > Manchester Royal Infirmary
> > England
> > [log in to unmask]
> > Evidence based Emergency Medicine
> > http://www.bestbets.org
> >
> > ----- Original Message -----
> > From: Bill Bailey <[log in to unmask]>
> > To: <[log in to unmask]>
> > Sent: Saturday, April 21, 2001 3:37 AM
> >
> >
> > > Re: Prophylactic antibiotics & Chest drains
> > >
> > > On the subject of prophylactic antibiotics, what do list members feel
> > about
> > > the administration of 1 shot of IV broad spectrum antibiotic just
prior
> to
> > > chest drain insertion [in trauma] to reduce the incidence of empyema?
> > >
> > > Bill Bailey
> > > A&E Chesterfield
> > >
> >
>
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