000			03855nam a22005177a 4500
008			190724s20192019 xxu||||| |||| 00| 0 eng d
022			_a2163-0755
024			_a01586154-201907001-00019 [pii]
024			_a10.1097/TA.0000000000002244 [doi]
040			_aOvid MEDLINE(R)
099			_a31246916
245			_aThoraSite: A device to improve accuracy of lateral decompression needle and chest tube placement.
251			_aThe Journal of Trauma and Acute Care Surgery. 87(1S Suppl 1):S128-S131, 2019 07.
252			_aJ Trauma Acute Care Surg. 87(1S Suppl 1):S128-S131, 2019 07.
252			_zJ Trauma Acute Care Surg. 87(1S Suppl 1):S128-S131, 2019 Jul.
253			_aThe journal of trauma and acute care surgery
260			_c2019
260			_fFY2020
265			_sppublish
266			_d2019-07-24
268			_aThe Journal of Trauma and Acute Care Surgery. 87(1S Suppl 1):S128-S131, 2019 Jul.
501			_aAvailable online from MWHC library: 1995 - present, Available in print through MWHC library: 1999 - 2006
520			_aBACKGROUND: 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.
520			_aCONCLUSION: ThoraSite use was associated with needle placement in the third, fourth, or fifth 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.
520			_aLEVEL OF EVIDENCE: Therapeutic and care management, level IV.
520			_aMETHODS: 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 axillary line (AAL) and midaxillary line (MAL); and percent correct placement (defined as the third, fourth, or fifth ICS from 1 cm anterior to the AAL to 1 cm posterior to the MAL).
520			_aRESULTS: The six female and six male cadavers spanned 4 ft and 11 inches (150 cm) to 6 ft and 7 inches (201 cm), 80 lb (36 kg) to 350 lb (159 kg), and 16 kg/m to 42 kg/m body mass index. All 24 needles were placed in either the third (4 [17%] of 24 needles), fourth (10 [42%] of 24 needles), or fifth ICS (10 [42%] of 24 needles). In 10 (42%) of 24 assessments, two ICSs were palpable in ThoraSite's Safe Zone. All palpable ICSs were either the third (8 [24%] of 34), fourth (15 [44%] of 34); or fifth ICS (11 [32%] of 34). Twenty-three (96%) of 24 needles were inserted from 1 cm anterior to the AAL to 1 cm posterior to the MAL. Twenty-three (96%) of 24 needle placements were correct.
546			_aEnglish
650			_a*Chest Tubes
650			_a*Decompression, Surgical/is [Instrumentation]
650			_a*Needles
650			_a*Thoracostomy/is [Instrumentation]
650			_aCadaver
650			_aDimensional Measurement Accuracy
650			_aFemale
650			_aHumans
650			_aMale
650			_aThoracic Wall/ah [Anatomy & Histology]
651			_aMedStar Medical Group
656			_aEmergency Medicine
657			_aJournal Article
700			_aShah, Amit Navin
790			_aDheer S, Kothera CS, Shah AN
856			_uhttps://dx.doi.org/10.1097/TA.0000000000002244 _zhttps://dx.doi.org/10.1097/TA.0000000000002244
942			_cART _dArticle
999			_c4474 _d4474