• Login
    View Item 
    •   UMB Digital Archive
    • School of Medicine
    • Faculty, Student Works School of Medicine
    • View Item
    •   UMB Digital Archive
    • School of Medicine
    • Faculty, Student Works School of Medicine
    • View Item
    JavaScript is disabled for your browser. Some features of this site may not work without it.

    Browse

    All of UMB Digital ArchiveCommunitiesPublication DateAuthorsTitlesSubjectsThis CollectionPublication DateAuthorsTitlesSubjects

    My Account

    LoginRegister

    Statistics

    Display statistics

    Comparison of a novel, endoscopic chest tube insertion technique versus the standard, open technique performed by novice users in a human cadaver model: A randomized, crossover, assessor-blinded study

    • CSV
    • RefMan
    • EndNote
    • BibTex
    • RefWorks
    Find Full text
    Author
    Drumheller, Byron C.
    Basel, Anthony
    Adnan, Sakib
    Rabin, Joseph
    Pasley, Jason D.
    Brocker, Jason
    Galvagno, Samuel M.
    Date
    2018-12-27
    Journal
    Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
    Type
    Article
    
    Metadata
    Show full item record
    See at
    https://dx.doi.org/10.1186/s13049-018-0574-2
    Abstract
    Background: The technique of tube thoracostomy has been standardized for years without significant updates. Alternative procedural methods may be beneficial in certain prehospital and inpatient environments with limited resources. We sought to compare the efficacy of chest tube insertion using a novel, endoscopic device (The Reactor™) to standard, open tube thoracostomy. Methods: Novice users were randomly assigned to pre-specified sequences of six chest tube insertions performed on a human cadaver model in a crossover design, alternating between the Reactor™ and standard technique. All subjects received standardized training in both procedures prior to randomization. Insertion site, which was randomly assigned within each cadaver's hemithorax, was marked by the investigators; study techniques began with skin incision and ended with tube insertion. Adequacy of tube placement (intrapleural, unkinked, not in fissure) and incision length were recorded by investigators blinded to procedural technique. Insertion time and user-rated difficulty were documented in an unblinded fashion. After completing the study, participants rated various aspects of use of the Reactor™ compared to the standard technique in a survey evaluation. Results: Sixteen subjects were enrolled (7 medical students, 9 paramedics) and performed 92 chest tube insertions (n = 46 Reactor™, n = 46 standard). The Reactor™ was associated with less frequent appropriate tube positioning (41.3% vs. 73.9%, P = 0.0029), a faster median insertion time (47.3 s, interquartile range 38-63.1 vs. 76.9 s, interquartile range 55.3-106.9, P < 0.0001) and shorter median incision length (28 mm, interquartile range 23-30 vs. 32 mm, interquartile range 26-40, P = 0.0034) compared to the standard technique. Using a 10-point Likert scale (1-easiest, 10-hardest) participants rated the ease of use of the Reactor™ no different from the standard method (3.8 ± 1.9 vs. 4.7 ± 1.9, P = 0.024). The Reactor™ received generally favorable scores for all parameters on the post-participation survey. Conclusions: In this randomized, assessor-blinded, crossover human cadaver study, chest tube insertion using the Reactor™ device resulted in faster insertion time and shorter incision length, but less frequent appropriate tube placement compared with the standard technique. Additional studies are needed to evaluate the efficacy, safety and potential advantages of this novel device. © 2018 The Author(s).
    Sponsors
    This work was partially sponsored by Sharp Medical Products, LLC, who provided funding for the Reactor™ devices and human cadaver use. No sponsors were involved in the collection, management or analysis of the data; preparation of the manuscript; or the decision to submit the manuscript for publication.
    Keyword
    emergency care
    human cadaver
    trauma
    tube thoracostomy
    Chest Tubes
    Identifier to cite or link to this item
    https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85059248035&origin=inward; http://hdl.handle.net/10713/8518
    ae974a485f413a2113503eed53cd6c53
    10.1186/s13049-018-0574-2
    Scopus Count
    Collections
    Faculty, Student Works School of Medicine

    entitlement

    Related articles

    • An Evaluation of a Novel Medical Device Versus Standard Interventions in the Treatment of Tension Pneumothorax in a Swine Model (Sus scrofa).
    • Authors: Sheldon RR, Do WS, Forte DM, Weiss JB, Derickson MJ, Eckert MJ, Martin MJ
    • Issue date: 2020 Feb 12
    • Small tube thoracostomy (20-22 Fr) in emergent management of chest trauma.
    • Authors: Tanizaki S, Maeda S, Sera M, Nagai H, Hayashi M, Azuma H, Kano KI, Watanabe H, Ishida H
    • Issue date: 2017 Sep
    • Visually guided tube thoracostomy insertion comparison to standard of care in a large animal model.
    • Authors: Hernandez MC, Vogelsang D, Anderson JR, Thiels CA, Beilman G, Zielinski MD, Aho JM
    • Issue date: 2017 Apr
    • A technique for visual confirmation of intrathoracic placement of tube thoracostomy using a fiberoptic laryngoscope in a cadaver.
    • Authors: Aho JM, Ruparel RK, Schiller HJ
    • Issue date: 2015 Apr
    • Evaluation of performance of two different chest tubes with either a sharp or a blunt tip for thoracostomy in 100 human cadavers.
    • Authors: Ortner CM, Ruetzler K, Schaumann N, Lorenz V, Schellongowski P, Schuster E, Salem RM, Frass M
    • Issue date: 2012 Feb 2
    DSpace software (copyright © 2002 - 2023)  DuraSpace
    Quick Guide | Policies | Contact Us | UMB Health Sciences & Human Services Library
    Open Repository is a service operated by 
    Atmire NV
     

    Export search results

    The export option will allow you to export the current search results of the entered query to a file. Different formats are available for download. To export the items, click on the button corresponding with the preferred download format.

    By default, clicking on the export buttons will result in a download of the allowed maximum amount of items.

    To select a subset of the search results, click "Selective Export" button and make a selection of the items you want to export. The amount of items that can be exported at once is similarly restricted as the full export.

    After making a selection, click one of the export format buttons. The amount of items that will be exported is indicated in the bubble next to export format.