Dr. Sacchetti reviews the insertion of a pigtail chest tube.
EM:RAP 2022 October Pediatric Pearls: Pneumothorax Smackdown
Really nice, clear video and easy to follow instructions. I only have one comment; for most spontaneous pneumos, I've been simply aspirating them, not leaving any tube in there, observe in the ED for a few hours with a repeat CXR, discharge and have the patient have follow up CXR's as an outpatient.Any comment about that approach?
Is all this equipment from a commercially available kit? If so, what kit are you using? If you are assembling all of the pieces individually, what are you using?
The Wayne Pneumothorax kit is the one we use at my hospital. It has everything pictured on his set-up.
Caution when aspirating pneumothorax that has been ongoing for some time--my case 10 days. Acutely expanding collapsed lung can cause significant V/Q mismatch and problems.
Instead of manual inspiration, what about just utilizing suction before allowing them to sit up?
That seems like a good question. Have you tried this?
This! I was thinking the same thing... any problems if you connect to suction?
Great video. I placed one in a vented covid patient, and it flopped down over the diaphragm. Now I understand why and how to prevent that.
I have questions about the pig tail catheter chest tube video:
1. What is the different between aspirating with a syringe at the end of the procedure vs just hooking the pigtail up to a pleurovac. It seems like the pleurovac suction would do the same thing and quicker?
2. Do you have any idea why the pigtail was developed the way it was over simply having a small french straight chest tube. What I am wondering, is what the pig tail actually does better than a small chest tube? Does the pig tail form better around the lung tissue?
Our hospital carries the Wayne kit that has a flutter valve. We have had patients that have pleural fluid escape through the flutter valve. Any suggestions on a commercially available container for fluid to drain into?
What you do matters.