Sonographic Identification of Tube Thoracostomy Study (SITTS): Confirmation of Intrathoracic Placement
Introduction: Thoracostomy tubes (TT) are commonly placed in the management of surgical, emergency, and trauma patients and chest radiographs (CXR) and computed tomography (CT) are performed to confirm placement. Ultrasound (US) has not previously been used as a means to confirm intrathoracic placem...
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| Format: | Article |
| Language: | English |
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eScholarship Publishing, University of California
2012-09-01
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| Series: | Western Journal of Emergency Medicine |
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| Online Access: | http://escholarship.org/uc/item/5r57s0kq |
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| author | Jamie A. Jenkins Laleh Gharahbaghian Stephanie J. Doniger Scott Bradley Steve Crandall David A. Spain Sarah R. Williams |
| author_facet | Jamie A. Jenkins Laleh Gharahbaghian Stephanie J. Doniger Scott Bradley Steve Crandall David A. Spain Sarah R. Williams |
| author_sort | Jamie A. Jenkins |
| collection | DOAJ |
| description | Introduction: Thoracostomy tubes (TT) are commonly placed in the management of surgical, emergency, and trauma patients and chest radiographs (CXR) and computed tomography (CT) are performed to confirm placement. Ultrasound (US) has not previously been used as a means to confirm intrathoracic placement of chest tubes. This study involves a novel application of US to demonstrate chest tubes passing through the pleural line, thus confirming intrathoracic placement.Methods: This was an observational proof-of-concept study using a convenience sample of patients with TTs at a tertiary-care university hospital. Bedside US was performed by the primary investigatorusing first the low-frequency (5–1 MHz) followed by the high-frequency (10–5 MHz) transducers, in both 2-dimensional gray-scale and M-modes in a uniform manner. The TTs were identified in transverse and longitudinal views by starting at the skin entry point and scanning to where the TT passed the pleural line, entering the intrathoracic region. All US images were reviewed by US fellowship-trained emergency physicians. CXRs and CTs were used as the standard for confirmation ofTT placement.Results: Seventeen patients with a total of 21 TTs were enrolled. TTs were visualized entering the intrathoracic space in 100% of cases. They were subjectively best visualized with the high-frequency (10–5 MHz) linear transducer. Sixteen TTs were evaluated using M-mode. TTs produced a distinct pattern on M-mode.Conclusion: Bedside US can visualize the TT and its entrance into the thoracic cavity and it can distinguish it from the pleural line by a characteristic M-mode pattern. This is best visualized with the high-frequency (10–5 MHz) linear transducer. [West J Emerg Med. 2012;13(4):305–311.] |
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| format | Article |
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| institution | Directory Open Access Journal |
| issn | 1936-900X 1936-9018 |
| language | English |
| last_indexed | 2024-12-10T12:30:32Z |
| publishDate | 2012-09-01 |
| publisher | eScholarship Publishing, University of California |
| record_format | Article |
| series | Western Journal of Emergency Medicine |
| spelling | doaj.art-3a904363061749c68abc3cee83e3ec862022-12-22T01:48:50ZengeScholarship Publishing, University of CaliforniaWestern Journal of Emergency Medicine1936-900X1936-90182012-09-01134305311Sonographic Identification of Tube Thoracostomy Study (SITTS): Confirmation of Intrathoracic PlacementJamie A. JenkinsLaleh GharahbaghianStephanie J. DonigerScott BradleySteve CrandallDavid A. SpainSarah R. WilliamsIntroduction: Thoracostomy tubes (TT) are commonly placed in the management of surgical, emergency, and trauma patients and chest radiographs (CXR) and computed tomography (CT) are performed to confirm placement. Ultrasound (US) has not previously been used as a means to confirm intrathoracic placement of chest tubes. This study involves a novel application of US to demonstrate chest tubes passing through the pleural line, thus confirming intrathoracic placement.Methods: This was an observational proof-of-concept study using a convenience sample of patients with TTs at a tertiary-care university hospital. Bedside US was performed by the primary investigatorusing first the low-frequency (5–1 MHz) followed by the high-frequency (10–5 MHz) transducers, in both 2-dimensional gray-scale and M-modes in a uniform manner. The TTs were identified in transverse and longitudinal views by starting at the skin entry point and scanning to where the TT passed the pleural line, entering the intrathoracic region. All US images were reviewed by US fellowship-trained emergency physicians. CXRs and CTs were used as the standard for confirmation ofTT placement.Results: Seventeen patients with a total of 21 TTs were enrolled. TTs were visualized entering the intrathoracic space in 100% of cases. They were subjectively best visualized with the high-frequency (10–5 MHz) linear transducer. Sixteen TTs were evaluated using M-mode. TTs produced a distinct pattern on M-mode.Conclusion: Bedside US can visualize the TT and its entrance into the thoracic cavity and it can distinguish it from the pleural line by a characteristic M-mode pattern. This is best visualized with the high-frequency (10–5 MHz) linear transducer. [West J Emerg Med. 2012;13(4):305–311.]http://escholarship.org/uc/item/5r57s0kqbedside ultrasoundchest tube placementprocedure |
| spellingShingle | Jamie A. Jenkins Laleh Gharahbaghian Stephanie J. Doniger Scott Bradley Steve Crandall David A. Spain Sarah R. Williams Sonographic Identification of Tube Thoracostomy Study (SITTS): Confirmation of Intrathoracic Placement Western Journal of Emergency Medicine bedside ultrasound chest tube placement procedure |
| title | Sonographic Identification of Tube Thoracostomy Study (SITTS): Confirmation of Intrathoracic Placement |
| title_full | Sonographic Identification of Tube Thoracostomy Study (SITTS): Confirmation of Intrathoracic Placement |
| title_fullStr | Sonographic Identification of Tube Thoracostomy Study (SITTS): Confirmation of Intrathoracic Placement |
| title_full_unstemmed | Sonographic Identification of Tube Thoracostomy Study (SITTS): Confirmation of Intrathoracic Placement |
| title_short | Sonographic Identification of Tube Thoracostomy Study (SITTS): Confirmation of Intrathoracic Placement |
| title_sort | sonographic identification of tube thoracostomy study sitts confirmation of intrathoracic placement |
| topic | bedside ultrasound chest tube placement procedure |
| url | http://escholarship.org/uc/item/5r57s0kq |
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