Etablering av thoraxdrenasje hos pasienter i luftambulanseavdelingen ved Oslo universitetssykehus -Et treårsmateriale og en gjennomgang av litteraturen

Abstract

Background: Prehospital pleural decompression is established when a tension pneumothorax is suspected. This is a life threatening condition that may lead to quick death if adequate treatment is not implemented immediately. This study is looking at the incidence of this procedure in a helicopter emergency service (HEMS) in Norway. Methods: This is a retrospective study of all pleural decompressions performed by HEMS physicians during a three-year period. This part of the study was accomplished by a review of the electronic journals in Labas and the following information was collected: age, gender, indications, complications, diagnosis and degree of severity (measured by GCS- and NACA-score). In addition, a literature study was performed to evaluate the scientific evidence. The inclusion criteria included human and English studies from the last twenty years. There was no restriction regarding the professional background of the person performing the procedure. Results: A total of 39 prehospital pleural decompressions were performed during the study period. This included 32 men and 7 women with an average age of 47.7 years. Three paediatric patients were included. There was a significant correlation between gender and drainage (p=0,025), but no significant correlation between age and drainage (p=0,14). Hypoxia was reported in two cases. 24 patients had GCS <9 and 13 had NACA-score 7. There was a significant correlation between NACA-score and drainage (p=0,0001). The mean on-scene time was 34 minutes. In the literature study, a total of 819 unique references were identified, 11 articles were retrieved in full text and 10 studies were included. Conclusions: Prehospitalt pleural drainage was performed in 1.0 percent of the cases. High severity among the patients demonstrates that it is the most critical patients who need this kind of treatment prehospitally. No complications were reported, but further studies are required.