Thoracic decompression point: New recommendation from ATLS 10
DOI:
https://doi.org/10.33448/rsd-v12i13.43787Keywords:
Advanced trauma life support care; Decompression, surgical; Pneumothorax.Abstract
The collection of liquid or gaseous fluids in the pleural cavity is a frequente occurence in thoracic trauma victims. The presence of content in space between parietal and visceral pleurae causes failure of the negative pressure needed for lung function, which induces lung tidal volume restriction and consequential acute breathing insufficiency for restrictive cause. Life-threatening thoracic injury can result from airway obstruction, tracheal bronchial tree injury, tension pneumothorax, open pneumothorax, massive hemothorax, and cardiac tamponade. Nevertheless, most of these injuries can be managed through relatively simple maneuvers such as airway control or chest decompression. However, subsequent editions of Advanced Trauma Life Support (ATLS) describe different approaches to the analyzed technique, in regard to the access to the thoracic cavity. This study aims to present a bibliographic review concerning the technical and anatomical considerations used by American College of Surgeons (ACS) Committee on Trauma (COT) for the decision to change the surgical intervention in the chest decompression maneuver, as well as the analysis of the different techniques described in 2012, in the ninth ATLS edition, and 2018, the tenth and most recent protocol update.
References
Abib, S. C. V, & Perfeito, J. A. J. (2012). Guia de trauma. Brasil.
American College of Surgeons. (2012). Pneumotorax hipertensivo. Advanced Trauma Life Support (ATLS). (9a ed.). Chicago, IL.
American College of Surgeons. (2018). Algorítmo de PCR Traumática. Advanced Trauma Life Support (ATLS). (10a ed.). Chicago, IL.
ATLS Subcommittee, American College of Surgeons’ Committee on Trauma, International ATLS working group. (2013). Advanced trauma life support (ATLS®): the ninth edition. Journal of Trauma and Acute Care Surgery, 74(5), 1363-1366.
Ball, C. G., et al. (2009). A caveat to the performance of pericardial ultrasound in patients with penetrating cardiac wounds. Atlanta, Estados Unidos: Journal of Trauma.
Carmont, M. R. (2005). The Advanced Trauma Life Support course: a history of its development and review of related literature. Postgraduate Medical Journal. 81 (952): 87-91.
Clancy, K., et al. (2012). Screening for blunt cardiac injury: an Eastern Association for the Surgery of Trauma practice management guideline. Journal of Trauma. 73(5 Suppl4), S301–S306.
Colicott, P. E. (1992) Advanced Trauma Life Support (ATLS): past, present, future--16th Stone Lecture, J Trauma. 33(5):749-53.
Cook, J. et al. (2006) The effect of changing presentation and management on the outcome of blunt rupture of the thoracic aorta. J Thorac Cardiovasc Surg. (3):594–600.
Demetriades, D., et al. (2008). Diagnosis and treatment of blunt aortic injuries: changing perspectives. Journal of Trauma. 64, 1415–1419.
Demetriades, D., et al. (2008). Operative repair or endovascular stent graft in blunt traumatic thoracic aortic injuries: results of an American Association for the Surgery of Trauma multicenter study. Journal of Trauma. 64, 561–571.
Dunhan, C. M., et al. (2003). Guidelines for emergency tracheal intubation immediately following traumatic injury: an EAST Practice Management Guidelines Workgroup. Journal of Trauma. 55, 162–179.
Ekeh, A. P., et al. (2008). Is chest x-ray an adequate screening tool for the diagnosis of blunt thoracic aortic injury? Journal of Trauma. 65, 1088–1092.
Flagel, B., et al. (2005). Half a dozen ribs: the breakpoint for mortality. Surgery. 138, 717–725.
Galvagno, S. M., et al. (2019). Advanced Trauma Life Support® Update 2019. Anesthesiology Clinics. 10.1016/j.anclin.2018.09.009.
Harcke, H. T., et al. (2007). Chest wall thickness in military personnel: implications for needle thoracentesis in tension pneumothorax. Military Medicine. 172(120), 1260–1263.
Harris, T, & Leigh-Smith, S. (2005). Tension pneumothorax – time for a re-think? Emergency Medicine Journal. 22:8-16.
Hershberger, R. C., et al. (2009). Endovascular grafts for treatment of traumatic injury to the aortic arch and great vessels. Journal of Trauma. 67(3), 660–671.
Radvinsky, D. S., et al. (2012). Evolution and development of the Advanced Trauma Life Support (ATLS) protocol: a historical perspective. Orthopedics. 35(4): 305-11.
Sousa, A. S, Oliveira, G. S, & Alves, L. H. (2021). A pesquisa bibliográfica: princípios e fundamentos. Cadernos da Fucamp. 20 (43), 64-83
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2023 Jonas Silva Pereira do Amaral; Luísa Henriques Penteado Borges; Sarah Oliveira Resende; André Luis Perez Solera
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
1) Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
2) Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
3) Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.
