ThoraSite: A device to improve accuracy of lateral decompression needle and chest tube placement.

ThoraSite: A device to improve accuracy of lateral decompression needle and chest tube placement. - 2019

BACKGROUND: Multiple reports have detailed an unacceptably high error rate in the siting of decompression needles and tubes and describe associated iatrogenic injuries. The objective of the current study was to measure the accuracy of the novel ThoraSite template for identifying an acceptable intercostal space (ICS) for lateral needle or tube thoracostomy. CONCLUSIONS: ThoraSite use was associated with needle placement in the 3, 4, or 5 ICS in an area roughly spanning the AAL to MAL in anatomically diverse cadavers. By facilitating appropriate needle/tube placement, ThoraSite use may decrease iatrogenic injuries. Future study involving representative users may be useful to further evaluate ThoraSite accuracy. LEVEL OF EVIDENCE: Level IV STUDY TYPE: Therapeutic and care management. METHODS: Two trained operators used the ThoraSite to place radiopaque needles in the left and right lateral chests of 12 cadavers. An independent radiologist reviewed fluoroscopy images to determine the primary outcome: the ICS in which each needle was placed. Secondary outcomes were ICS's palpable through ThoraSite's Safe Zone; needle placement relative to the anterior (AAL) and mid-axillary (MAL) lines; and percent correct placement (defined as the 3, 4, or 5 ICS from 1cm anterior to the AAL to 1cm posterior to the MAL). RESULTS: The 6 female and 6 male cadavers spanned 4'11" (150cm) to 6'7" (201cm), 80lb (36kg) to 350lb (159kg), and 16 kg/m to 42 kg/m BMI. All 24 needles were placed in either the 3 (4/24 needles, 17%); 4 (10/24 needles, 42%); or 5 ICS (10/24 needles, 42%). In 10/24 assessments (42%), two ICS's were palpable in ThoraSite's Safe Zone. All palpable ICS's were either the 3 (8/34, 24%); 4 (15/34, 44%); or 5 ICS (11/34, 32%). 23/24 needles (96%) were inserted from 1cm anterior to the AAL to 1cm posterior to the MAL. 23/24 needle placements (96%) were correct.


English

2163-0755

10.1097/TA.0000000000002244 [doi]


IN PROCESS -- NOT YET INDEXED


MedStar Medical Group


Emergency Medicine


Journal Article

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