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Bing F, Fitzgerald M, Olaussen A, Finnegan P, O'Reilly G, Gocentas R, Stergiou H, Korin A, Marasco S, McGiffin D. Identifying a safe site for intercostal catheter insertion using the mid-arm point (MAP). Journal of Emergency Medicine, Trauma and Acute Care 2017. [DOI: 10.5339/jemtac.2017.3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Background: Over 85% of chest injuries requiring surgical intervention can be managed with tube thoracostomy/intercostal catheter (ICC) insertion alone. However, complication rates of ICC insertion have been reported in the literature to be as high as 37%. Insertional complications, including the incorrect identification of the safe zone chest wall location for ICC placement, are common issues, with up to 41% of insertions occurring outside of this safe area. A new biometric approach using the patient's proportional skeletal upper limb anatomy to allow correct identification of the chest wall skin site for ICC insertion may reduce complications. Aim: The aim of this study was to examine the performance of the mid-arm point (MAP) method in identifying the safe zone for ICC insertion. Methods: Thirty healthy volunteers were recruited from The Alfred Hospital, a Level I Adult Trauma Centre in Melbourne, Australia. Blinded investigators used the MAP to measure the mid-point of the adducted arm of each volunteer bilaterally. A skin marking was placed on the anterior axillary line of the adjacent chest wall, and with the arm then abducted to 90 degrees, the underlying intercostal space was identified. Results: Using the MAP method, all of the 120 measurements fell within the ‘safe zone’ of the fourth to sixth intercostal spaces bilaterally. The median intercostal space identified was the fifth space, with investigators finding this in 86% of measurements independent of age, sex, height, weight or side. Conclusion: A simple technique using the MAP is a reliable marker for the identification of the safe zone for ICC insertion in healthy volunteers. The clinical utility for patients undergoing pleural decompression and drainage needs prospective evaluation.
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Affiliation(s)
- Fei Bing
- 1Trauma Service, The Alfred Hospital, Melbourne, Victoria, Australia
- 2National Trauma Research Institute, Melbourne, Victoria, Australia
- 5Central Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Mark Fitzgerald
- 1Trauma Service, The Alfred Hospital, Melbourne, Victoria, Australia
- 2National Trauma Research Institute, Melbourne, Victoria, Australia
- 5Central Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Alexander Olaussen
- 5Central Clinical School, Monash University, Melbourne, Victoria, Australia
- 1Trauma Service, The Alfred Hospital, Melbourne, Victoria, Australia
- 6Department of Community Emergency Health and Paramedic Practice, Monash University, Melbourne, Victoria, Australia
- 3Emergency & Trauma Centre, The Alfred, Hospital, Melbourne, Victoria, Australia
- 2National Trauma Research Institute, Melbourne, Victoria, Australia
| | - Pete Finnegan
- 1Trauma Service, The Alfred Hospital, Melbourne, Victoria, Australia
- 2National Trauma Research Institute, Melbourne, Victoria, Australia
- 3Emergency & Trauma Centre, The Alfred, Hospital, Melbourne, Victoria, Australia
| | - Gerard O'Reilly
- 2National Trauma Research Institute, Melbourne, Victoria, Australia
- 3Emergency & Trauma Centre, The Alfred, Hospital, Melbourne, Victoria, Australia
- 5Central Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Rob Gocentas
- 2National Trauma Research Institute, Melbourne, Victoria, Australia
- 3Emergency & Trauma Centre, The Alfred, Hospital, Melbourne, Victoria, Australia
| | - Helen Stergiou
- 2National Trauma Research Institute, Melbourne, Victoria, Australia
- 3Emergency & Trauma Centre, The Alfred, Hospital, Melbourne, Victoria, Australia
| | - Anna Korin
- 3Emergency & Trauma Centre, The Alfred, Hospital, Melbourne, Victoria, Australia
| | - Silvana Marasco
- 4Department of Cardiothoracic Surgery, The Alfred Hospital, Melbourne, Victoria, Australia
- 5Central Clinical School, Monash University, Melbourne, Victoria, Australia
| | - David McGiffin
- 4Department of Cardiothoracic Surgery, The Alfred Hospital, Melbourne, Victoria, Australia
- 5Central Clinical School, Monash University, Melbourne, Victoria, Australia
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Kuhajda I, Zarogoulidis K, Kougioumtzi I, Huang H, Li Q, Dryllis G, Kioumis I, Pitsiou G, Machairiotis N, Katsikogiannis N, Papaiwannou A, Lampaki S, Papaiwannou A, Zaric B, Branislav P, Porpodis K, Zarogoulidis P. Tube thoracostomy; chest tube implantation and follow up. J Thorac Dis 2014; 6:S470-9. [PMID: 25337405 DOI: 10.3978/j.issn.2072-1439.2014.09.23] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2014] [Accepted: 09/01/2014] [Indexed: 01/12/2023]
Abstract
Pneumothorax is an urgent medical situation that requires urgent treatment. We can divide this entity based on the etiology to primary and secondary. Chest tube implantation can be performed either in the upper chest wall or lower. Both thoracic surgeons and pulmonary physicians can place a chest tube with minimal invasive techniques. In our current work, we will demonstrate chest tube implantation to locations, methodology and tools.
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Affiliation(s)
- Ivan Kuhajda
- 1 Thoracic Surgery Department, Institute for Pulmonary Diseases of Vojvodina, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia; 2 Pulmonary Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Surgery Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece ; 4 Department of Respiratory Diseases Shanghai Hospital, II Military University Hospital, Shanghai 200433, China ; 5 Hematology Department, "Laiko" University General Hospital, Athens, Greece ; 6 Obstetric - Gynecology Department, "Thriassio" General Hospital of Athens, Athens, Greece ; 7 Institute for Pulmonary Diseases of Vojvodina, Clinic for Thoracic Oncology, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
| | - Konstantinos Zarogoulidis
- 1 Thoracic Surgery Department, Institute for Pulmonary Diseases of Vojvodina, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia; 2 Pulmonary Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Surgery Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece ; 4 Department of Respiratory Diseases Shanghai Hospital, II Military University Hospital, Shanghai 200433, China ; 5 Hematology Department, "Laiko" University General Hospital, Athens, Greece ; 6 Obstetric - Gynecology Department, "Thriassio" General Hospital of Athens, Athens, Greece ; 7 Institute for Pulmonary Diseases of Vojvodina, Clinic for Thoracic Oncology, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
| | - Ioanna Kougioumtzi
- 1 Thoracic Surgery Department, Institute for Pulmonary Diseases of Vojvodina, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia; 2 Pulmonary Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Surgery Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece ; 4 Department of Respiratory Diseases Shanghai Hospital, II Military University Hospital, Shanghai 200433, China ; 5 Hematology Department, "Laiko" University General Hospital, Athens, Greece ; 6 Obstetric - Gynecology Department, "Thriassio" General Hospital of Athens, Athens, Greece ; 7 Institute for Pulmonary Diseases of Vojvodina, Clinic for Thoracic Oncology, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
| | - Haidong Huang
- 1 Thoracic Surgery Department, Institute for Pulmonary Diseases of Vojvodina, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia; 2 Pulmonary Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Surgery Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece ; 4 Department of Respiratory Diseases Shanghai Hospital, II Military University Hospital, Shanghai 200433, China ; 5 Hematology Department, "Laiko" University General Hospital, Athens, Greece ; 6 Obstetric - Gynecology Department, "Thriassio" General Hospital of Athens, Athens, Greece ; 7 Institute for Pulmonary Diseases of Vojvodina, Clinic for Thoracic Oncology, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
| | - Qiang Li
- 1 Thoracic Surgery Department, Institute for Pulmonary Diseases of Vojvodina, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia; 2 Pulmonary Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Surgery Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece ; 4 Department of Respiratory Diseases Shanghai Hospital, II Military University Hospital, Shanghai 200433, China ; 5 Hematology Department, "Laiko" University General Hospital, Athens, Greece ; 6 Obstetric - Gynecology Department, "Thriassio" General Hospital of Athens, Athens, Greece ; 7 Institute for Pulmonary Diseases of Vojvodina, Clinic for Thoracic Oncology, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
| | - Georgios Dryllis
- 1 Thoracic Surgery Department, Institute for Pulmonary Diseases of Vojvodina, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia; 2 Pulmonary Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Surgery Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece ; 4 Department of Respiratory Diseases Shanghai Hospital, II Military University Hospital, Shanghai 200433, China ; 5 Hematology Department, "Laiko" University General Hospital, Athens, Greece ; 6 Obstetric - Gynecology Department, "Thriassio" General Hospital of Athens, Athens, Greece ; 7 Institute for Pulmonary Diseases of Vojvodina, Clinic for Thoracic Oncology, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
| | - Ioannis Kioumis
- 1 Thoracic Surgery Department, Institute for Pulmonary Diseases of Vojvodina, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia; 2 Pulmonary Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Surgery Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece ; 4 Department of Respiratory Diseases Shanghai Hospital, II Military University Hospital, Shanghai 200433, China ; 5 Hematology Department, "Laiko" University General Hospital, Athens, Greece ; 6 Obstetric - Gynecology Department, "Thriassio" General Hospital of Athens, Athens, Greece ; 7 Institute for Pulmonary Diseases of Vojvodina, Clinic for Thoracic Oncology, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
| | - Georgia Pitsiou
- 1 Thoracic Surgery Department, Institute for Pulmonary Diseases of Vojvodina, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia; 2 Pulmonary Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Surgery Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece ; 4 Department of Respiratory Diseases Shanghai Hospital, II Military University Hospital, Shanghai 200433, China ; 5 Hematology Department, "Laiko" University General Hospital, Athens, Greece ; 6 Obstetric - Gynecology Department, "Thriassio" General Hospital of Athens, Athens, Greece ; 7 Institute for Pulmonary Diseases of Vojvodina, Clinic for Thoracic Oncology, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
| | - Nikolaos Machairiotis
- 1 Thoracic Surgery Department, Institute for Pulmonary Diseases of Vojvodina, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia; 2 Pulmonary Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Surgery Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece ; 4 Department of Respiratory Diseases Shanghai Hospital, II Military University Hospital, Shanghai 200433, China ; 5 Hematology Department, "Laiko" University General Hospital, Athens, Greece ; 6 Obstetric - Gynecology Department, "Thriassio" General Hospital of Athens, Athens, Greece ; 7 Institute for Pulmonary Diseases of Vojvodina, Clinic for Thoracic Oncology, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
| | - Nikolaos Katsikogiannis
- 1 Thoracic Surgery Department, Institute for Pulmonary Diseases of Vojvodina, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia; 2 Pulmonary Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Surgery Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece ; 4 Department of Respiratory Diseases Shanghai Hospital, II Military University Hospital, Shanghai 200433, China ; 5 Hematology Department, "Laiko" University General Hospital, Athens, Greece ; 6 Obstetric - Gynecology Department, "Thriassio" General Hospital of Athens, Athens, Greece ; 7 Institute for Pulmonary Diseases of Vojvodina, Clinic for Thoracic Oncology, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
| | - Antonis Papaiwannou
- 1 Thoracic Surgery Department, Institute for Pulmonary Diseases of Vojvodina, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia; 2 Pulmonary Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Surgery Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece ; 4 Department of Respiratory Diseases Shanghai Hospital, II Military University Hospital, Shanghai 200433, China ; 5 Hematology Department, "Laiko" University General Hospital, Athens, Greece ; 6 Obstetric - Gynecology Department, "Thriassio" General Hospital of Athens, Athens, Greece ; 7 Institute for Pulmonary Diseases of Vojvodina, Clinic for Thoracic Oncology, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
| | - Sofia Lampaki
- 1 Thoracic Surgery Department, Institute for Pulmonary Diseases of Vojvodina, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia; 2 Pulmonary Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Surgery Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece ; 4 Department of Respiratory Diseases Shanghai Hospital, II Military University Hospital, Shanghai 200433, China ; 5 Hematology Department, "Laiko" University General Hospital, Athens, Greece ; 6 Obstetric - Gynecology Department, "Thriassio" General Hospital of Athens, Athens, Greece ; 7 Institute for Pulmonary Diseases of Vojvodina, Clinic for Thoracic Oncology, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
| | - Antonis Papaiwannou
- 1 Thoracic Surgery Department, Institute for Pulmonary Diseases of Vojvodina, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia; 2 Pulmonary Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Surgery Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece ; 4 Department of Respiratory Diseases Shanghai Hospital, II Military University Hospital, Shanghai 200433, China ; 5 Hematology Department, "Laiko" University General Hospital, Athens, Greece ; 6 Obstetric - Gynecology Department, "Thriassio" General Hospital of Athens, Athens, Greece ; 7 Institute for Pulmonary Diseases of Vojvodina, Clinic for Thoracic Oncology, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
| | - Bojan Zaric
- 1 Thoracic Surgery Department, Institute for Pulmonary Diseases of Vojvodina, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia; 2 Pulmonary Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Surgery Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece ; 4 Department of Respiratory Diseases Shanghai Hospital, II Military University Hospital, Shanghai 200433, China ; 5 Hematology Department, "Laiko" University General Hospital, Athens, Greece ; 6 Obstetric - Gynecology Department, "Thriassio" General Hospital of Athens, Athens, Greece ; 7 Institute for Pulmonary Diseases of Vojvodina, Clinic for Thoracic Oncology, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
| | - Perin Branislav
- 1 Thoracic Surgery Department, Institute for Pulmonary Diseases of Vojvodina, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia; 2 Pulmonary Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Surgery Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece ; 4 Department of Respiratory Diseases Shanghai Hospital, II Military University Hospital, Shanghai 200433, China ; 5 Hematology Department, "Laiko" University General Hospital, Athens, Greece ; 6 Obstetric - Gynecology Department, "Thriassio" General Hospital of Athens, Athens, Greece ; 7 Institute for Pulmonary Diseases of Vojvodina, Clinic for Thoracic Oncology, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
| | - Konstantinos Porpodis
- 1 Thoracic Surgery Department, Institute for Pulmonary Diseases of Vojvodina, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia; 2 Pulmonary Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Surgery Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece ; 4 Department of Respiratory Diseases Shanghai Hospital, II Military University Hospital, Shanghai 200433, China ; 5 Hematology Department, "Laiko" University General Hospital, Athens, Greece ; 6 Obstetric - Gynecology Department, "Thriassio" General Hospital of Athens, Athens, Greece ; 7 Institute for Pulmonary Diseases of Vojvodina, Clinic for Thoracic Oncology, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
| | - Paul Zarogoulidis
- 1 Thoracic Surgery Department, Institute for Pulmonary Diseases of Vojvodina, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia; 2 Pulmonary Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Surgery Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece ; 4 Department of Respiratory Diseases Shanghai Hospital, II Military University Hospital, Shanghai 200433, China ; 5 Hematology Department, "Laiko" University General Hospital, Athens, Greece ; 6 Obstetric - Gynecology Department, "Thriassio" General Hospital of Athens, Athens, Greece ; 7 Institute for Pulmonary Diseases of Vojvodina, Clinic for Thoracic Oncology, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
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