Evaluating emergency department tube thoracostomy

This study examined the procedural variability and technical complications of tube thoracostomy performed in emergency departments through a review of trauma videos from 2020 to 2022. The research focused on differentiating between patients with hemodynamically normal and abnormal conditions, hypothesizing that hemodynamic instability would complicate the procedure. Of the 51 videos reviewed, those in hemodynamically abnormal patients had significantly lower performance scores (8 vs. 10) and quicker times to pleural entry and completion compared to their stable counterparts. Despite these challenges, malpositioning was the most common complication observed, with no significant difference between the two groups.

The findings highlight significant variability in procedural outcomes, particularly linked to the patient's hemodynamic status, emphasizing the need for standardized benchmarks and better training methods. The use of trauma video review proved beneficial in identifying these discrepancies, suggesting that similar methodologies could enhance the evaluation and training of procedural skills in emergency medicine.