A spring-loaded needle for emergency evacuation of pneumothorax

Pulmonary complications of the McSwain Dart

We evaluated the McSwain Dart on a "worst case" basis. Dogs were sedated with 30 mg/kg pentobarbital, intubated, and placed on 15 cm H2O positive end-expiratory pressure. Percutaneous introduction of the McSwain Dart was not possible without parenchymal damage to the lung in over 20 attempts under these conditions. The McSwain Dart should be used only when the diagnosis of pneumothorax is without doubt.

Complications of tube thoracostomy for acute trauma

Closed tube thoracostomy is a common and very useful procedure in therapy of acute thoracic injury. However, it is not without risk. With aggressive use of this procedure in the emergency department, the incidence of technical complications was 1 percent. Our review suggests that complications can be further diminished by the routine use of large thoracostomy tubes that are placed well up on the chest after confirmation of an open pleural space, by avoiding the use of a trocar for tube placement, and by the use of a high volume, low pressure suction system. Empyema was the most common complication associated with tube thoracostomy after trauma. It occurred in 2.4 percent of the patients. Its exact causes is not known, and the role of prophylactic antibiotics needs to be established.