Paramedic PapersHome Trauma Finger thoracostomy beats needle decompression in cadavers
Trauma
Finger thoracostomy beats needle decompression in cadavers
Comparison of needle decompression to simple (finger) thoracostomy in non-perfused cadaveric models with theoretical tension pneumothorax
Prehospital Emergency Care · Added 30 April 2026
Cadaveric crossover study testing needle decompression versus simple thoracostomy for theoretical tension pneumothorax — simple thoracostomy was more successful and faster, but the model limits clinical certainty.
- Study type
- Simulation
- Design
- Prospective simulation-based experimental crossover study in fresh cadavers
- Participants
- 38 paired attempts in cadaveric models
- Main finding
- Simple thoracostomy relieved theoretical tension pneumothorax in 92.1% vs 76.3% for needle decompression; full relief to 0 mmHg in 60.5% vs 28.9% (p = 0.004); thoracostomy was faster (11.9 vs 34.1 s)
- Caveat
- Cadaveric model with artificially created tension pneumothorax; may not reflect clinical performance
- Bottom line
- Hypothesis-generating
Learning goal
Weigh the benefits and limitations of finger thoracostomy versus needle decompression for tension pneumothorax in my trauma practice.
More
- Topic: Trauma
- Daily scan: 30 April 2026
Related papers on Trauma
-
Each advanced prehospital intervention adds scene time
Retrospective physician-led HEMS trauma study examining whether more advanced interventions are stretching scene times — each additional intervention increased scene time by 41%, although overall scene times stayed similar over two decades because of changing case mix.
-
Call to abandon routine spinal immobilisation
Commentary challenging continued routine spinal immobilisation in suspected spinal injury — the authors argue decades of evidence now consistently show harm without benefit, and that paramedic scope should evolve to reflect current evidence.
-
Normal CT safely rules out delayed bleed on anticoagulants
Retrospective review tested whether immediate discharge after normal CT was safe for anticoagulated head-injury patients with GCS 14-15 — no delayed intracranial haemorrhage, neurosurgical intervention, or clinically significant deterioration occurred.
-
US statewide protocols for prehospital blood vary