Colorimetric capnography adjunct during prehospital needle decompression of tension pneumothorax improves decompression success and reduces need for repeat prehospital decompression - 25/11/25
, L.J. Relle, BBA b , Charles P. Burnell, MD a Abstract |
Background |
Tension pneumothorax is not uncommon. Effective Decompression of tension pneumothorax is lifesaving. Current guidelines recommend needle decompression (ND) as the initial decompression procedure. The metric of successful decompression is for operators to use “a gush of air” and monitor changes in vital signs. Effective needle decompression for tension pneumothorax in the prehospital environment is challenging. Studies report consistently a high failure rate of decompression. We hypothesize treatment of tension pneumothorax with needle decompression incorporating colorimetric indication as the initial decompression modality may improve initial decompression success rates and lower the need for additional decompression procedures such as finger thoracostomy.
Study design and methods |
Prospective enrollment of trauma patients before and after deployment of Colorimetric Assisted Needle Decompression (CAND). Patients who underwent needle decompression in a prehospital setting were included. Eligible patients received either ND, or CAND. The primary endpoint of this study was clinical success rate of initial decompression. Secondary outcomes included the number of repeat decompression procedures performed and decompression type: ND, CAND, or finger thoracostomy.
Results |
30 patients underwent ND and 11 patients underwent CAND. There were no statistically significant differences in patients age, sex, or trauma type. Performing ND without CAND resulted in an overall initial decompression success rate of 66 % compared to 82 % when using CAND. There was an overall reduction in need for repeat needle decompression 9 % vs 17 % and conversion to finger thoracostomy, also 9 % and 17 % when using CAND.
Conclusion |
Initial decompression utilizing colorimetric detection of CO2 improves initial procedural success, with demonstrably less need for repeat procedures or conversion to finger thoracostomy for treatment of tension pneumothorax. We recommend initial decompression utilizing needle decompression coupled with a colorimetric CO2 sensing device. Future guideline revisions should consider recommending initial needle decompression be coupled with CO2 colorimetry.
Le texte complet de cet article est disponible en PDF.Keywords : Tension pneumothorax, Finger thoracostomy, Needle thoracostomy, Paramedics, Pleural decompression, Needle decompression, Prehospital, Advanced trauma life support (ATLS), Colorimetric capnography, Emergency medical systems/service (EMS)
Plan
Vol 98
P. 256-261 - décembre 2025 Retour au numéro
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