we use them (Cook seldinger chest drains)in selected
patients - very expensive - 30 quid instead of 3 I
seem to remember. The unconscious or stoical adults
get the old style ones, kids and the squeamish or
non-traumatic ones tend to get a seldinger.
Interesting point about size, but I would stick to an
old style large drain in a multiply injured patient
with a haemothorax
--- Andy Webster
<[log in to unmask]> wrote:
> 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
> Andy Webster
> -----Original Message-----
> From: Accident and Emergency Academic List
> [mailto:[log in to unmask]]On Behalf Of
> [log in to unmask]
> Sent: 30 April 2002 17:51
> To: [log in to unmask]
> Subject: Re: chest drains - how big??
> Good question Simon, even large drains clot from
> time to time, and you've
> just got to be wary of that, and be prepared to
> flush them from time to
> time. Are smaller drains any more likely to clot
> off? Who knows, but I can
> see a bestbet coming on...
> Adrian Fogarty
> > from: "s.carley" <[log in to unmask]>
> > date: Tue, 30 Apr 2002 08:40:31
> > to: [log in to unmask]
> > subject: Re: chest drains - how big??
> > Standard teaching for chest drains in trauma is
> "big is best". In the past
> > this has been determined by 2 factors.
> > 1. The concept that bigger drains are less likely
> to get blocked.
> > 2. You put your finger in during the insertion
> procedure therefore you may
> > as well put something in as big as your finger
> since that is how big the
> > hole now is!
> > We have recently started using the seldinger chest
> drains (Cook) which
> > been discussed on the list previously (and I like
> them a lot).
> > However, it has taken away reason 2 for putting a
> big drain in. So how big
> > does a drain REALLY need to be to drain blood and
> air in trauma????
> > Simon
> > NB. We use smaller drains in kids - though
> because it is rare I am
> > if they do block off all the time.
> > Simon Carley
> > SpR in Emergency Medicine
> > [log in to unmask]
> > Evidence based emergency medicine
> > http://www.bestbets.org
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