Tube Thoracostomy Part 1

DUSTOFF Medic Podcast

Dr. Sean Stuart joins Claire and Morgan for the first in a two-part series about chest tubes. Dr. Stuart is a Navy emergency medicine physician and is the Research Director of the Combat Trauma Research Group.
This first episode covers a lot of ground, from a detailed discussion of the procedure itself to a thorough exploration of a recent paper contrasting the efficacy of traditional chest tubes against pigtail catheters.
Dr. Stuart calls out a couple important pearls, notably that oxygenation status is a very late finding for tension hemo/pneumothorax, and separately, that breath sounds are unreliable in determining whether a patient has this type of injury.
A recent paper gets some attention in this episode, and really illustrates why it's important to dig deeper than the abstract and conclusion:

• Kulvatunyou, N., Bauman, Z. M., Zein Edine, S. B., de Moya, M., Krause, C., Mukherjee, K., Gries, L., Tang, A. L., Joseph, B., & Rhee, P. (2021). The small (14 Fr) percutaneous catheter (P-CAT) versus large (28-32 Fr) open chest tube for traumatic hemothorax: A multicenter randomized clinical trial. The journal of trauma and acute care surgery, 91(5), 809–813.

You can find this paper through your free (to the military) institutional login via OpenAthens. There's also a good summary at criticalcarenow.com.
Have a listen and let us know what you think!