Intercostal catheter insertion: are we really doing well?

ANZ Journal of Surgery
Rashid AlrahbiZsolt J Balogh

Abstract

Intercostal catheters (ICC) are the standard management of chest trauma, but are associated with complications in up to 30%. The aim of this study was to evaluate errors in technique during ICC insertion to characterize the potential benefit of improved training programmes. Prospective audit of all ICC in trauma patients at a level 1 trauma centre for over 12 months. Exclusions were pigtail catheters and ICC inserted during thoracic surgery. Errors were identified from patient examination and chest imaging; they were defined as insertional, positional, incorrect size (<28 French) and lack of antibiotic prophylaxis. Ongoing complications unrelated to an error in technique, for example blocked tube, were not analysed. Fifty-seven patients received a total of 94 ICC during the study period. Patients were predominantly male (77%), mean age of 40 ± 20 years, mean injury severity score 27 ± 13, mean abbreviated injury scale chest 3.8 ± 0.72. 86% were blunt trauma and 14% penetrating chest injuries. Thirty-six errors in technique occurred in 33 ICC insertions (38%). The most common errors were absence of prophylactic antibiotics (13%), ICC too far out (9%), kinked (6%) and wrong-sized ICC (5%). Emergency had a significantly greater fr...Continue Reading

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Citations

May 17, 2014·American Journal of Respiratory and Critical Care Medicine·Te-Chun ShenChih-Yen Tu
Nov 6, 2012·ANZ Journal of Surgery·Valery Usatoff
Jun 4, 2015·European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society·V Y KongD L Clarke
Dec 5, 2018·ANZ Journal of Surgery·Christina Popovic, Pankaj Saxena
Apr 16, 2019·Critical Care Medicine·Scott A HelgesonJose L Diaz-Gomez
May 2, 2019·Emergency Medicine Australasia : EMA·Warwick J TeagueNuala Quinn
Jun 27, 2018·Turkish Journal of Emergency Medicine·Jessica MckeeAndrew W Kirkpatrick
Aug 13, 2015·Annals of the Royal College of Surgeons of England·V Y KongD L Clarke
Oct 29, 2014·Annals of the Royal College of Surgeons of England·V Y KongD L Clarke
Jul 6, 2021·The Journal of Trauma and Acute Care Surgery·Jeremy Adam SmithEdoardo Aromataris

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