J Korean Soc Traumatol.  2012 Jun;25(2):37-43.

Complications of a Tube Thoracostomy Performed by Emergency Medicine Residents

Affiliations
  • 1Department of Thoracic and Cardiovascular Surgery, College of Medicine, Chung-Ang University, Korea.
  • 2Department of Emergency Medicine, College of Medicine, Ewha Womans University, Korea.
  • 3Major in Preventive Medicine, Department of Medical College, The Graduate School Chung-Ang University, Korea. crimza@daum.net

Abstract

PURPOSE
A tube thoracostomy is an invasive procedure that places patients at risk for complications. Tube thoracostomies are frequently performed by emergency medicine residents. Thus, the purpose of the study was to assess both the complication rate for tube thoracostomies performed by emergency medicine residents and the factors associated with these complications.
METHODS
A retrospective chart review of all patients who had undergone a tube thoracostomy performed by emergency medicine residents between January 2008 and February 2009 was conducted at a university hospital. Complications were divided into major and minor complications and into immediate and delayed complications. Complications requiring corrective surgical intervention, requiring the administration of blood products, or involving situations requiring intravenous antibiotics were defined as major. Complications that were detected within 2 hours were defined as immediate.
RESULTS
Tube thoracostomies were performed in 189 patients, and 70 patients(37%) experienced some complications. Most complications were immediate and minor. In multiple logistic regressions, BMI, hypotension and resident seniority were significantly associated with complications.
CONCLUSION
The prevalence of complications was similar to these in previous reports on the complications of a tube thoracostomy. Most complications from tube thoracostomies performed by emergency medicine residents were immediate and minor complications. Thus, emergency medicine residents should be allowed to perform closed tube thoracostomies instead of thoracic surgeons.

Keyword

Tube thoracostomy; Complications; Emergency medicine residents

MeSH Terms

Anti-Bacterial Agents
Emergencies
Emergency Medicine
Humans
Hypotension
Logistic Models
Prevalence
Retrospective Studies
Thoracostomy
Anti-Bacterial Agents
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