Sonographic evaluation of chest wall thickness in Chinese adults in Hong Kong: Should the updated (10th edition) Advance Trauma Life Support guidelines on preferred site of needle thoracocentesis in tension pneumothorax be adopted in the Asian population?
| Autor: | Stephanie Dorothy Pui-Ming Yu, James Siu Ki Lau, Ka Leung Mok, Pui Gay Kan |
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| Rok vydání: | 2020 |
| Předmět: |
021110 strategic
defence & security studies medicine.medical_specialty business.industry 0211 other engineering and technologies Needle decompression Chinese adults 030208 emergency & critical care medicine 02 engineering and technology Critical Care and Intensive Care Medicine Tension pneumothorax Surgery 03 medical and health sciences 0302 clinical medicine Life support Emergency Medicine medicine Asian population Bedside ultrasound Wall thickness business |
| Zdroj: | Trauma. 23:120-126 |
| ISSN: | 1477-0350 1460-4086 |
| DOI: | 10.1177/1460408620934361 |
| Popis: | Objective To compare the anterior with lateral mean chest wall thickness measured by bedside ultrasound in Chinese adults in order to suggest a preferred site for needle decompression in tension pneumothorax. Study design This was an observational cross-sectional study conducted in a regional hospital over three months. Subjects were recruited by convenience sampling. Chest wall thickness at the second intercostal space, mid clavicular line, fifth intercostal space, anterior axillary line and fifth intercostal space and mid axillary line was measured using ultrasound on both sides. Range, mean values and confidence intervals were calculated. Results One-hundred and fourteen subjects were recruited. The mean anterior chest wall thickness was 2.62 cm (at second intercostal space, mid-clavicular line) and mean lateral chest wall was 2.68 cm (at fifth intercostal space, anterior axillary line) and 2.87 cm (at fifth intercostal space and mid-axillary line) respectively. Chest wall thickness at fifth intercostal space and mid-axillary line was significantly greater than second intercostal space, mid-clavicular line ( p Conclusion There is a need for population-based guidelines. We recommend needle decompression at the second intercostal space, mid-clavicular line with a 50-mm angiocath for Chinese patients with tension pneumothorax. A lateral approach at the fifth intercostal space, anterior axillary line may be considered as an alternative in case of failure. Prehospital point-of-care ultrasound may be a useful adjunct in managing such patients. |
| Databáze: | OpenAIRE |
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