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Prehospital minithoracostomy vs chest drain

Prehospital Minithoracostomy versus Chest Drainage for Emergency Pleural Decompression in Major Trauma
Prehospital Emergency Care · Added 29 September 2026

Retrospective physician-led HEMS cohort (94 trauma patients) comparing prehospital minithoracostomy with chest drainage — minithoracostomy carried no meaningful scene-time penalty and fewer recorded complications, but non-random allocation and few events make it hypothesis-generating only.

Study type

Cohort

Design

Retrospective physician-led HEMS cohort with Bayesian analysis

Participants

94 major trauma adults (66 minithoracostomy, 28 chest drainage)

Main finding

Posterior median scene-time difference −5.9 minutes (95% CrI −13.8 to 1.7); recorded complications 0/50 evaluable minithoracostomy vs 6/10 evaluable chest drainage (risk difference −58.7 percentage points, 95% CrI −83.9 to −29.3); no clear survival differences at 1, 30 or 90 days.

Caveat

Non-randomised allocation by clinical judgment, complication ascertainment differed between groups, and very few events.

Bottom line

Hypothesis-generating

Learning goal

Weigh the benefits and limitations of finger thoracostomy compared with chest drainage for traumatic pleural decompression in my practice.

More

• Topic: Trauma
• Daily scan: 29 September 2026
• Podcast: Paramedic Papers Daily, 29 September 2026

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