Background: Emergent placement of a chest tube is a potentially life-saving procedure, but rate of misplacement\r\nand organ injury is up to 30%. In principle, chest tube insertion can be performed by using Trocar or Non-trocar\r\ntechniques. If using trocar technique, two different chest tubes (equipped with sharp or blunt tip) are currently\r\ncommercially available. This study was performed to detect any difference with respect to time until tube insertion,\r\nto success and to misplacement rate.\r\nMethods: Twenty emergency physicians performed five tube thoracostomies using both blunt and sharp tipped\r\ntube kits in 100 fresh human cadavers (100 thoracostomies with each kit). Time until tube insertion served as\r\nprimary outcome. Complications and success rate were examined by pathological dissection and served as further\r\noutcomes parameters.\r\nResults: Difference in mean time until tube insertion (63s vs. 59s) was statistically not significant. In both groups,\r\ntime for insertion decreased from the 1st to the 5th attempt and showed dependency on the cadaver�s BMI and on\r\nthe individual physician. Success rate differed between both groups (92% using blunt vs. 86% using sharp tipped\r\nkits) and injuries and misplacements occurred significantly more frequently using chest tubes with sharp tips (p =\r\n0.04).\r\nConclusion: Data suggest that chest drain insertion with trocars is associated with a 6-14% operator-related\r\ncomplication rate. No difference in average time could be found. However, misplacements and organ injuries\r\noccurred more frequently using sharp tips. Consequently, if using a trocar technique, the use of blunt tipped kits is\r\nrecommended.
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