Exploring the use of ultrasound for safer chest tube insertion, comparing accuracy to anatomic landmarks. Discussion on diaphragm movement, challenges in identifying insertion points, and benefits of ultrasound guidance. Study on fifth intercostal space location and call for listener ideas for research studies.
Ultrasound can identify potential complications in chest tube placement, emphasizing precision to avoid injuries.
Females show higher diaphragm complication rates, indicating the need for safer chest tube insertion methods.
Deep dives
Ultrasound vs. Anatomic Landmarks for Chest Tube Placement
A study compared the accuracy of ultrasound versus anatomic landmarks for locating the fifth intercostal space for chest tube placement. Patients in the emergency room who could lift their arms were included in the study. Results showed that ultrasound identified potential complications in 19% of cases, highlighting the importance of precise tube placement to avoid diaphragm or organ injury.
Potential Complications and Gender Differences
Among the findings, females had a higher percentage of diaphragm complications compared to males. The study emphasized the significance of correct tube placement to prevent adverse outcomes, especially in emergency situations. These complications were observed in asymptomatic patients, raising concerns about the safety of traditional chest tube placement methods.
Importance of Point of Care Ultrasound and Future Directions
The study suggested a potential role for point-of-care ultrasound in guiding safe chest tube placements. It highlighted the need for further research on time to placement and success rates using ultrasound. The authors encouraged exploring ultrasound-guided procedures to improve patient safety and reduce complications.
Placing a tube thoracostomy (aka chest tube) is a very useful procedure but can have complications of injuring the diaphragm or intraabdominal organs. Traditionally, the location for placement is selected using anatomic landmarks to find the correct intercostal space. This study questions the safety of this traditional location by using point-of-care ultrasound to visualize diaphragm movement during respirations. Is this the start of ultrasound-assisted chest tubes?
https://www.ultrasoundgel.org/94
https://pubmed.ncbi.nlm.nih.gov/32333800/
Get the Snipd podcast app
Unlock the knowledge in podcasts with the podcast player of the future.
AI-powered podcast player
Listen to all your favourite podcasts with AI-powered features
Discover highlights
Listen to the best highlights from the podcasts you love and dive into the full episode
Save any moment
Hear something you like? Tap your headphones to save it with AI-generated key takeaways
Share & Export
Send highlights to Twitter, WhatsApp or export them to Notion, Readwise & more
AI-powered podcast player
Listen to all your favourite podcasts with AI-powered features
Discover highlights
Listen to the best highlights from the podcasts you love and dive into the full episode