Episode 33: Tube Thoracostomy (Part 1)

With Dr. Sean Stuart

Dr. Sean Stuart joins Claire and Morgan for the first in a two-part series about chest tubes. Dr. Stuart is a Navy emergency medicine physician and is the Research Director of the Combat Trauma Research Group.

This first episode covers a lot of ground, from a detailed discussion of the procedure itself to a thorough exploration of a recent paper contrasting the efficacy of traditional chest tubes against pigtail catheters. 

Dr. Stuart calls out a couple of important pearls, notably that oxygenation status is a very late finding for tension hemo/pneumothorax, and separately, that breath sounds are unreliable in determining whether a patient has this type of injury.

A recent paper gets some attention in this episode, and really illustrates why it’s important to dig deeper than the abstract and conclusion: 

  • Kulvatunyou, N., Bauman, Z. M., Zein Edine, S. B., de Moya, M., Krause, C., Mukherjee, K., Gries, L., Tang, A. L., Joseph, B., & Rhee, P. (2021). The small (14 Fr) percutaneous catheter (P-CAT) versus large (28-32 Fr) open chest tube for traumatic hemothorax: A multicenter randomized clinical trial. The journal of trauma and acute care surgery91(5), 809–813. 

You can find this paper through your free (to the military) institutional login via OpenAthens. There’s also a good summary at criticalcarenow.com.

Thanks for listening to the DUSTOFF Medic Podcast. If you enjoyed this episode and want to support the podcast, please share it with friends and colleagues, follow us on social media, and check out our other episodes. If you use these episodes in your training, send us a message and let us know!

Have a listen and let us know what you think!

About the Author

You may also like these