05/11/2025
El tamaño importa?🧐
𝐃𝐨𝐞𝐬 𝐒𝐢𝐳𝐞 𝐌𝐚𝐭𝐭𝐞𝐫? 💉
You’re treating a trauma patient with suspected tension pneumothorax.
You insert a needle for decompression… but are you using the right kind and size of catheter?
A new cadaveric study says your choice could make the difference between success and failure.
Today, we break down�a new study titled "𝐅𝐞𝐧𝐞𝐬𝐭𝐫𝐚𝐭𝐞𝐝 𝐂𝐚𝐭𝐡𝐞𝐭𝐞𝐫𝐬 𝐀𝐫𝐞 𝐒𝐮𝐩𝐞𝐫𝐢𝐨𝐫 𝐭𝐨 𝐍𝐨𝐧-𝐅𝐞𝐧𝐞𝐬𝐭𝐫𝐚𝐭𝐞𝐝 𝐍𝐞𝐞𝐝𝐥𝐞 𝐓𝐡𝐨𝐫𝐚𝐜𝐨𝐬𝐭𝐨𝐦𝐲 𝐂𝐚𝐭𝐡𝐞𝐭𝐞𝐫𝐬 𝐢𝐧 𝐚 𝐂𝐚𝐝𝐚𝐯𝐞𝐫𝐢𝐜 𝐓𝐞𝐧𝐬𝐢𝐨𝐧 𝐏𝐧𝐞𝐮𝐦𝐨𝐭𝐡𝐨𝐫𝐚𝐱 𝐌𝐨𝐝𝐞𝐥" (𝘗𝘳𝘦𝘩𝘰𝘴𝘱𝘪𝘵𝘢𝘭 𝘌𝘮𝘦𝘳𝘨𝘦𝘯𝘤𝘺 𝘊𝘢𝘳𝘦, 𝘈𝘶𝘨 2025)
🔍 What they did:
👉 Researchers tested the following catheters in fresh human cadavers
a. 14 ga fenestrated
b. 14 ga non-fenestrated
c. 10 ga fenestrated
d. 10 ga non-fenestrated
👉 Tension pneumothorax was induced and then relieved using the different catheter types at both the 2nd ICS mid-clavicular and 5th ICS anterior-axillary line.
📊 Key Findings:
1️⃣ Success rate for relieving pressure:
Fenestrated catheters worked 84% of the time vs only 44% for non-fenestrated (p < 0.01).
2️⃣ Time to decompression:
10 ga was faster than 14 ga (21.2 sec vs 36.0 sec, p = 0.01), but fenestration had a bigger impact than gauge size.
3️⃣ Audible air release:
Heard in 88% of fenestrated cases vs 69% with non-fenestrated (p = 0.06).
4️⃣ Insertion site matters:
At the 2nd ICS MCL, fenestrated catheters had a 94% success rate, compared to just 25% with non-fenestrated (p < 0.01).
🚑 Takeaway for EMS:
✔️ If you’re using needle decompression in the field, fenestrated catheters should be your go-to.
✔️ Protocols and equipment should evolve to reflect this superior performance, especially in anterior chest placements.
Kudos to study authors Adam Kruse, Jennifer Achay, Emily Epley, Jeff Swenson, Brian Ferguson, Jeffrey R., Erik DeSoucy, DO, FACS, Shannon Thompson, and David Wampler.
🔗 Read the full study here: https://ow.ly/91kG50XlO7N
