PT  - JOURNAL ARTICLE
AU  - LTC Jacob Chen
AU  - Capt Roy Nadler
AU  - Maj Dagan Schwartz
AU  - Col Homer Tien
AU  - LTC Andrew P. Cap
AU  - Col Elon Glassberg
TI  - Needle thoracostomy for tension pneumothorax: the Israeli Defense Forces experience
AID  - 10.1503/cjs.012914
DP  - 2015 Jun 01
TA  - Canadian Journal of Surgery
PG  - S118--S124
VI  - 58
IP  - 3 Suppl 3
4099  - http://canjsurg.ca/content/58/3_Suppl_3/S118.short
4100  - http://canjsurg.ca/content/58/3_Suppl_3/S118.full
SO  - CAN J SURG2015 Jun 01; 58
AB  - Background: Point of injury needle thoracostomy (NT) for tension pneumothorax is potentially lifesaving. Recent data raised concerns regarding the efficacy of conventional NT devices. Owing to these considerations, the Israeli Defense Forces Medical Corps (IDF-MC) recently introduced a longer, wider, more durable catheter for the performance of rapid chest decompression. The present series represents the IDF-MC experience with chest decompression by NT.Methods: We reviewed the IDF trauma registry from January 1997 to October 2012 to identify all cases in which NT was attempted.Results: During the study period a total of 111 patients underwent chest decompression by NT. Most casualties (54%) were wounded as a result of gunshot wounds (GSW); motor vehicle accidents (MVAs) were the second leading cause (16%). Most (79%) NTs were performed at the point of injury, while the rest were performed during evacuation by ambulance or helicopter (13% and 4%, respectively). Decreased breath sounds on the affected side were one of the most frequent clinical indications for NT, recorded in 28% of cases. Decreased breath sounds were more common in surviving than in nonsurviving patients. (37% v. 19%, p < 0.001). A chest tube was installed on the field in 35 patients (32%), all after NT.Conclusion: Standard NT has a high failure rate on the battlefield. Alternative measures for chest decompression, such as the Vygon catheter, appear to be a feasible alternative to conventional NT.