Traumatic Pneumothorax; Roadside to Resus
Summary
This podcast episode deeply explores traumatic pneumothoraces, detailing their causes, impact, and varied clinical presentations in both spontaneously breathing and ventilated patients. It covers key diagnostic tools like X-ray, CT, and ultrasound, discussing their advantages and limitations. The discussion also spans pre-hospital and in-hospital management strategies, including needle decompression, open thoracostomy, and chest drains, critically examining current guidelines and introducing the ongoing CoMITED trial to address existing ambiguities.Episode description
This is the first of two episodes looking at pneumothoraces. In this episode we're going to start out by taking a look at traumatic pneumothoraces.
Traumatic pneumothoraces are present in about a fifth of multiple trauma patients, so it's not infrequent to come across them and they can obviously occur in those with isolated chest injury too. Thoracic trauma occurs in around two thirds of multi-trauma cases and is classified as the primary cause of death in a quarter of trauma patients.
The clinical assessment carries with it a fair amount of dogma, including looking for tensions with tracheal deviation, so we'll be running through what the signs we should look for actually mean.
Then we'll move on to a detailed discussion about investigation strategies before finally looking at the guidelines and evidence on the topic, including which we have to intervene with, which we probably shouldn't and those in which there is much uncertainty...
Once again we'd love to hear any comments or questions either via the website or social media.
Enjoy!
Simon, Rob & James
ps; if you're interested in getting your site involved with the CoMITED Trial then email comited-trial@bristol.ac.uk