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首页> 外文期刊>Prehospital emergency care >Incidence and outcome of tube thoracostomy positioning in Trauma patients
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Incidence and outcome of tube thoracostomy positioning in Trauma patients

机译：创伤患者开胸胸腔切开术定位的发生率和结果

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Objectives. To evaluate the frequency of use, placement site, success and misplacement rates, and need for intervention for tube thoracostomies (TTs), and the complications with endotracheal intubation associated with TT in the prehospital setting. Methods. We performed a five-year, retrospective study using the records of 1,065 patients who were admitted to the trauma emergency room at a university hospital and who had received chest radiographs or computed tomography (CT) scans within 30 minutes after admission. Results. Seven percent of all patients received a TT (5% unilateral, 2% bilateral). Ninety-seven percent of all patients with a TT were endotracheally intubated. The success rate for correctly placed chest tubes was 78%. Twenty-two percent of the chest tubes were misplaced (i.e., too far in the chest, twisted, or bent); half of those had to be corrected, with one needing to be replaced. There were no statistical differences in the frequency of Monaldi or Blau positions, or the frequency of left or right chest TT. In addition, the two positions did not differ in misplacement rates or the need for intervention. Helicopter emergency medical services physicians used the Monaldi position significantly more frequently than the Blau position. In-hospital physicians performing interhospital transfer used the Blau position significantly more frequently, whereas ground emergency medical physicians had a more balanced relationship between the two positions. Tube thoracostomy had no influence on endotracheal tube misplacement rates, and vice versa. Conclusion. Tube thoracostomy positioning mostly depends on the discretion of the physician on scene. The Monaldi and Blau positions do not differ in misplacement or complication rates.
机译：目标。为了评估使用频率，放置部位，成功率和错位率，以及在院前环境中是否需要进行介入性胸腔穿刺术（TT）的干预以及与TT相关的气管插管的并发症。方法。我们进行了一项为期五年的回顾性研究，使用了1065例患者的记录，这些患者被录入了大学医院的创伤急诊室，并在入院后30分钟内接受了胸部X光或计算机断层扫描（CT）扫描。结果。所有患者中有7％接受了TT（单侧5％，双侧2％）。在所有TT患者中，有97％经气管插管。正确放置胸管的成功率为78％。 22％的胸管放错了位置（即，胸部太远，扭曲或弯曲）;其中一半必须纠正，其中一个需要更换。 Monaldi或Blau位置的频率，或左或右胸部TT的频率均无统计学差异。此外，两个职位的错位率或干预需求没有差异。直升飞机急诊医疗医生使用Monaldi职位的频率明显高于Blau职位。进行院际转移的医院内医生使用Blau的位置明显更多，而地面急诊医生在两个位置之间的关系更为平衡。胸腔穿刺术对气管插管放错率没有影响，反之亦然。结论。胸腔穿刺术的位置主要取决于现场医生的判断。 Monaldi和Blau的位置在错位或并发症发生率上没有差异。

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