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Clamp the the chest tube in an EMS placed chest tube

oded private tangentcarrot at hotmail.com
Sat Apr 8 22:54:44 BST 2006

I have heard of a case that may qulify. It was presented to us by a trauma 
surgeon. who was not part of it.

>From what I remember (It was about two years ago):
Young man,  shot in the neck (assualt rifle). Intubated (why? expanding 
hematoma/low GCS. Don't remember. Anyhow, O2 Sat. was good before 
intubation- that I do remember) by the first crew, than the tube pulled out, 
later attempts by aircrew failed, so they went to cricothyroidotomy, and it 
all took quite a long time. Being so busy with his A, they weren't to 
vigilant about his B and C deteriorating, and once the airway was secured 
they took off, he died enroute/in the hospital (not sure). Post mortem CT 
showed large collection of interpleural air and a mediastinal shift.
Again- I'm not sure about the details, but the point remains. You might take 
it to the other extreme- with no field managment in the first place, maybe 
he would have made to the hospital soon enough to be chest tubed in trauma 
room (I think the time it would take him to get there "scoop&run" style 
would be 35-60 minutes from injury)

>From: KMATTOX at aol.com
>Reply-To: "Trauma & Critical Care mailing list" 
><trauma-list at trauma.org>
>To: trauma-list at trauma.org
>Subject: Re: Clamp the the chest tube in an EMS placed chest tube
>Date: Sat, 8 Apr 2006 16:39:52 EDT
>In a message dated 4/8/2006 1:47:33 P.M. Central Standard Time,
>Krin135 at aol.com writes:
>Then you  and Rick will be willing to testify Pro Bono for the  defense if 
>outlying trauma case with a suspicious chest injury does NOT  get a  chest
>by an appropriately trained crew and the patient dies  enroute  to the
>receiving trauma facility, having bypassed one or  more small town
>facilities (with
>ED docs who have a better  armamentarum available than the crew)  which are
>trauma  centers?
>I would be happy to review such a case, if and when such a case is produced
>and it falls into the data that you cite.   Quite honestly, I have not  
>or heard of such a case in military or civilian practice in the past  
>decades.   I HAVE seen a significant number of IATROGENIC (and  even FATAL)
>complications caused by such insertion if needles and tubes in the  
>helicopter, and non trauma center personnel.
>trauma-list : TRAUMA.ORG
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