title: Needle Thoracotomy in Trauma.
abstract: Tension pneumothorax is one of the leading causes of preventable death in trauma patients. Needle thoracotomy (NT) is the currently accepted first-line intervention but has not been well validated. In this review, we have critically discussed the evidence for NT procedure, re-examined the recommendations by the Advanced Trauma Life Support organization and investigated the safest and most effective way of NT. The current evidence to support the use of NT is limited. However, when used, it should be applied in the 2nd intercostal space at midclavicular line using a catheter length of at least 4.5 cm. Alternative measures should be studied for better prehospital management of tension pneumothorax.
authors.affiliation: Medical Corps, Surgeon General's HQ, Military POB 02149, Israel Defense Force, Israel.
authors.forename: Misgav
authors.initials: M
authors.lastname: Rottenstreich
authors.affiliation: Medical Corps, Surgeon General's HQ, Military POB 02149, Israel Defense Force, Israel.
authors.forename: Shmuel
authors.initials: S
authors.lastname: Fay
authors.affiliation: Medical Corps, Surgeon General's HQ, Military POB 02149, Israel Defense Force, Israel.
authors.forename: Sami
authors.initials: S
authors.lastname: Gendler
authors.affiliation: Divison of Acute Care Surgery and Trauma, Chaim Sheba Medical Center, Tel Hashomer, 52621, Israel.
authors.forename: Yoram
authors.initials: Y
authors.lastname: Klein
authors.affiliation: Unit of Pediatric Surgery, Shaare Zedek Hospital, Jerusalem, 91031, Israel.
authors.forename: Marc
authors.initials: M
authors.lastname: Arkovitz
authors.affiliation: Medical Corps, Surgeon General's HQ, Military POB 02149, Israel Defense Force, Israel.
authors.forename: Amihai
authors.initials: A
authors.lastname: Rottenstreich
mesh_terms: D006801:Humans; D008168:Lung / Q000503:physiopathology*; D055370:Lung Injury / Q000150:complications; D009339:Needles; D011030:Pneumothorax / Q000209:etiology / Q000601:surgery* / Q000628:therapy; D017410:Practice Guidelines as Topic; D013907:Thoracostomy; D013908:Thoracotomy / Q000379:methods; D014947:Wounds and Injuries