A comparison study of chest tube thoracostomy: Air medical crew and in-hospital trauma service

Critical care paramedics: where is the evidence? a systematic review

“…Two further publications compared HEMS paramedics with ground paramedics 25 29. Finally, three studies examined the effects of CCPs delivering specific interventions, such as tube thoracostomy,24 non-invasive ventilation26 and RSI 22. The most commonly represented countries (5/12) were the USA23–25 27 33 and Australia (3/12) 22 28 30.…”

“…On the other hand, Australian MICA paramedics receive extensive training in critical care and, due to targeted dispatch, regularly attend severely injured patients 22. Similarly, York et al 24 showed that a nurse/CCP HEMS crew can carry out prehospital chest tube thoracostomy with complication rates that are not different to those occurring in hospital. Like MICA paramedics, this HEMS team was only dispatched to high-acuity trauma, and placed 76 chest tubes over a period of 2 years.…”

“…We identified three studies which examined the effect of specific interventions delivered by CCPs, of which one showed a significant improvement22 and two showed no difference in their respective outcomes 24 26. The first study by Bernard et al 22 was a randomised controlled trial of MICA paramedics undertaking prehospital RSI versus basic airway manoeuvres prehospital followed by RSI in the receiving ED.…”

“…The a priori defined secondary outcome of ‘good neurologic recovery’ (GOSe 5–8) was achieved significantly more often in the CCP RSI group (51% vs 39%, respectively, p=0.046). York et al 24 compared the complication rates and mortality of trauma patients receiving a tube thoracostomy either by a CCP/nurse, HEMS crew, or by physicians in the receiving hospital after ground transport. Complication rates were equal between the groups, with ISS and unadjusted mortality higher in the HEMS group.…”

Verletzung der V. subclavia mit einer Thoraxdrainage

“…York et al [12] haben die Komplikationsrate nach Thoraxdrainageanlage bei 172 Patienten untersucht und konnten feststellen, dass die durch trainiertes medizinisches nichtärztliches Flugpersonal angelegten Thoraxdrainagen im Vergleich zu ärztlich angelegten nicht mehr Komplikationen aufwiesen [12]. Peek et al [8] geben zu bedenken, dass es bei der Insertion des Katheters allein durch die Schärfe der Katheterspitze zu Perforationen und Lazeratio-…”