Prehospital Needle Decompression of Suspected Tension Pneumothorax: Outcomes and Consequences

Harrison J Travis; Gilbert V Andry; Colin C Rutner; Elizabeth Lacy; Kaleb J Derouen; Michael Maristany; Alison A Smith; Patrick P Greiffenstein

doi:10.1177/00031348241241739

Prehospital Needle Decompression of Suspected Tension Pneumothorax: Outcomes and Consequences

Am Surg. 2024 Apr 5:31348241241739. doi: 10.1177/00031348241241739. Online ahead of print.

Authors

Harrison J Travis¹, Gilbert V Andry¹, Colin C Rutner², Elizabeth Lacy³, Kaleb J Derouen¹, Michael Maristany², Alison A Smith³, Patrick P Greiffenstein³

Affiliations

¹ School of Medicine, Louisiana State University Health Sciences Center, New Orleans, LA, USA.
² Department of Radiology, Louisiana State University Health Sciences Center, New Orleans, LA, USA.
³ Division of Trauma/Critical Care Surgery Department, Louisiana State University Health Sciences Center, New Orleans, LA, USA.

PMID: 38578102
DOI: 10.1177/00031348241241739

Abstract

Tension pneumothorax (TPT) identified in the prehospital setting requires prehospital needle decompression (PHND). This study aimed to evaluate complications from PHND when it was performed without meeting clinical criteria. A retrospective review was performed of patients undergoing (PHND) from 2016 through 2022 at a level 1 trauma center. Patient data who received PHND were reviewed. Of 115 patients, 85 did not meet at least one clinical criterion for PHND. The majority of patients in this cohort 76 (89%) required a chest tube and 22 (25%) had an iatrogenic pneumothorax from PHND. 5 patients (6%) were admitted due to iatrogenic PHND. Two vascular injuries in this population were directly due to PHND and required emergency operative repair. This study shows the negative consequences of PHND when performed without clear indications. Several patients underwent unnecessary procedures with significant clinical consequences.

Keywords: lungs; trauma; trauma acute care.