Introduction:
Thoracic trauma is contributing to 25% of trauma mortality. Thoracostomy is a lifesaving procedure by creating an opening in the chest wall and release the pressure within the thoracic cavity. It can be done by a simple needle thoracocentesis or by open thoracostomy.
Discussion:
Needle thoracocentesis has been practiced as first choice of methods for chest decompression in tension pneumothorax but study has showed that needle thoracocentesis is not the optimal method for chest decompression. The reason behind this is the location for needle thoracocentesis and the chest wall thickness which doesn’t reach the catheter length. Needle thoracocentesis also is blind method of thoracostomy which may raise to multiple complication such as iatrogenic injury to the chest vital structure. Finger thoracostomy is a safe method for chest decompression during resuscitation. Even though it is an invasive procedure, blunt dissection and direct visualization of the chest cavity makes it as a safe procedure during resuscitation. Finger thoracostomy also showed to be safe to practice in pre-hospital care setting.
Conclusion:
Finger thoracostomy is a safe method of chest decompression in unstable patient especially in traumatic cardiac arrest. This method should be replacing needle thoracocentesis which is not effective and can rise to a lot of iatrogenic complication.
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