Pre-hospital intercostal chest drains in South Africa: A modified Delphi study

Dippenaar, Enrico and Wallis, Lee (2019) Pre-hospital intercostal chest drains in South Africa: A modified Delphi study. African Journal of Emergency Medicine, 9 (2). pp. 91-95. ISSN 2211-419X

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Official URL: https://doi.org/10.1016/j.afjem.2019.01.003

Abstract

Introduction: Trauma is one of the most common causes of death in low- and middle-income countries, with thoracic injury accounting for 20–25% of these deaths worldwide. The current management of a life-threatening pre-hospital pneumothorax is with a needle chest decompression, however, definitive care for a pneumothorax and/or haemothorax is still the insertion of an intercostal chest drain. The aim of this study was to seek expert opinion and consensus on the placement of ICDs in the pre-hospital emergency care setting in South Africa. Methods: A three-round modified Delphi study was undertaken with an expert panel drawn from local emergency care experts consisting of physicians and emergency medical service practitioners. Participants supplied opinion statements in round 1 under headings derived from common emerging themes found in the literature. During round 2 participants used a 9-point Likert scale to rate their consensus on each statement and in round 3 they were able to change their position based on the earlier panel distributions. A consensus percentage of 60% was set within a narrow margin of ‘strongly agree’ or ‘strongly disagree’. Results: A total of 22 experts took part as panel members. There were 123 opinion statements produced from round 1, of which 21 (17%) reached consensus in round 2. At the end of round 3 another four statements reached consensus, bringing the total up to 25 (20%). Conclusion: Definitive care of a life-threating pneumothorax and/or haemothorax must be sought emergently. The insertion of an ICD, under select conditions, may be required in the pre-hospital setting in South Africa.

Item Type: Journal Article
Keywords: Intercostal Chest Drain, Pneumothorax, Haemothorax
Faculty: Faculty of Health, Education, Medicine & Social Care
Depositing User: Dr Enrico Dippenaar
Date Deposited: 22 Jan 2019 09:36
Last Modified: 14 Nov 2019 16:08
URI: http://arro.anglia.ac.uk/id/eprint/704033

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