کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
2604811 1134050 2014 5 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Air Transport of Patients with Pneumothorax: Is Tube Thoracostomy Required Before Flight?
ترجمه فارسی عنوان
حمل و نقل هوایی بیماران مبتلا به پنوموتوراکس: آیا توراکوستومی لوله لازم است قبل از پرواز؟
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی طب اورژانس
چکیده انگلیسی

ObjectiveIt is conventionally thought that patients with pneumothorax (PTX) require tube thoracostomy (TT) before air medical transport (AMT), especially in unpressurized rotor-wing (RW) aircraft, to prevent deterioration from expansion of the PTX or development of tension PTX. We hypothesize that patients with PTX transported without TT tolerate RW AMT without serious deterioration, as defined by hypotension, hypoxemia, respiratory distress, intubation, bag valve mask ventilation, needle thoracostomy (NT), or cardiac arrest during transport.MethodsWe conducted a retrospective review of a case-series of trauma patients transported to a single Level 1 trauma center via RW with confirmed PTX and no TT. Using standardized abstraction forms, we reviewed charts for signs of deterioration. Those patients identified as having clinical deterioration were independently reviewed for the likelihood that the clinical deterioration was a direct consequence of PTX.ResultsDuring the study period, 66 patients with confirmed PTX underwent RW AMT with an average altitude gain of 1890 feet, an average barometric pressure 586–600 mmHg, and average flight duration of 28 minutes. All patients received oxygen therapy; 14/66 patients (21%) were supported with positive pressure ventilation. Eleven of 66 patients (17%) had NT placed before flight and 4/66 (6%) had NT placed during flight. Four of 66 patients (6% CI0.3–11.7) may have deteriorated during AMT as a result of PTX; all were successfully managed with NT.ConclusionsIn this series, 6% of patients with PTX deteriorated as result of AMT without TT, yet all patients were managed successfully with NT. Routine placement of TT in patients with PTX before RW AMT may not be necessary. Further prospective evaluation is warranted.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Air Medical Journal - Volume 33, Issue 4, July–August 2014, Pages 152–156
نویسندگان
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