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Development and content validation of the checklist for assessing placement of a small‐bore chest tube (CAPS) for small‐bore chest tube placement

Development and content validation of the checklist for assessing placement of a small‐bore chest... INTRODUCTIONThe insertion of small‐bore chest tubes (SBCTs) involving the modified Seldinger technique is frequently performed by a variety of clinicians when treating pleural effusion, hemothorax, or pneumothorax. An SBCT may be the preferred type of chest tube in many of these instances because, compared to large‐bore chest tubes (LBCTs), SBCTs have been associated with less patient discomfort.1,2 Furthermore, according to one meta‐analysis, SBCTs may also be associated with lower complication rates and shorter hospital length of stay in the setting of pneumothorax.3SBCTs can nevertheless lead to several complications, with rates estimated from 5% to 15%,4–6 particularly in cases of suboptimal insertion technique. These include infection; hemothorax, pneumothorax, and parenchymal lung injury; and injury to other organs including heart, diaphragm, and abdominal organs.7 SBCTs are also prone to clogging, kinking, and dislodgement, risks that may be mitigated through certain procedural techniques.8 A root cause analysis of two chest tube–related complications identified lack of familiarity with the procedural steps as a key area of weakness and identified key steps that were more prone to operator error.9 Other studies have also identified key procedural steps as being associated with either higher success rates (e.g., use of ultrasound) or lower complication rates (e.g., http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png AEM Education and Training Wiley

Development and content validation of the checklist for assessing placement of a small‐bore chest tube (CAPS) for small‐bore chest tube placement

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References (20)

Publisher
Wiley
Copyright
Copyright © 2023 Society for Academic Emergency Medicine
eISSN
2472-5390
DOI
10.1002/aet2.10855
Publisher site
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Abstract

INTRODUCTIONThe insertion of small‐bore chest tubes (SBCTs) involving the modified Seldinger technique is frequently performed by a variety of clinicians when treating pleural effusion, hemothorax, or pneumothorax. An SBCT may be the preferred type of chest tube in many of these instances because, compared to large‐bore chest tubes (LBCTs), SBCTs have been associated with less patient discomfort.1,2 Furthermore, according to one meta‐analysis, SBCTs may also be associated with lower complication rates and shorter hospital length of stay in the setting of pneumothorax.3SBCTs can nevertheless lead to several complications, with rates estimated from 5% to 15%,4–6 particularly in cases of suboptimal insertion technique. These include infection; hemothorax, pneumothorax, and parenchymal lung injury; and injury to other organs including heart, diaphragm, and abdominal organs.7 SBCTs are also prone to clogging, kinking, and dislodgement, risks that may be mitigated through certain procedural techniques.8 A root cause analysis of two chest tube–related complications identified lack of familiarity with the procedural steps as a key area of weakness and identified key steps that were more prone to operator error.9 Other studies have also identified key procedural steps as being associated with either higher success rates (e.g., use of ultrasound) or lower complication rates (e.g.,

Journal

AEM Education and Training – Wiley

Published: Apr 1, 2023

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