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Mid-Arm Point in PAEDiatrics (MAPPAED): An effective procedural aid for safe pleural decompression in trauma.
Quinn, Nuala; Ward, Grantley; Ong, Cyril; Krieser, David; Melvin, Robert; Makhijani, Allya; Grindlay, Joanne; Lynch, Catherine; Colleran, Gabrielle; Perry, Victoria; O'Donnell, Sinead M; Law, Ian; Varma, Dinesh; Fitzgerald, John; Mitchell, Hannah J; Teague, Warwick J.
Afiliación
  • Quinn N; Department of Paediatric Emergency Medicine, Children's Health Ireland at Temple Street, Dublin, Ireland.
  • Ward G; Emergency Research Group, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.
  • Ong C; National Office for Trauma Services, Dublin, Ireland.
  • Krieser D; Melbourne Medical School, The University of Melbourne, Melbourne, Victoria, Australia.
  • Melvin R; Department of Medical Imaging, The Royal Children's Hospital, Melbourne, Victoria, Australia.
  • Makhijani A; Emergency Research Group, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.
  • Grindlay J; Melbourne Medical School, The University of Melbourne, Melbourne, Victoria, Australia.
  • Lynch C; Department of Emergency Medicine, Sunshine Hospital, Western Health, Melbourne, Victoria, Australia.
  • Colleran G; Department of Emergency Medicine, Sandringham Hospital, Alfred Health, Melbourne, Victoria, Australia.
  • Perry V; Department of Emergency Medicine, Sunshine Hospital, Western Health, Melbourne, Victoria, Australia.
  • O'Donnell SM; Emergency Research Group, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.
  • Law I; Department of Emergency Medicine, The Royal Children's Hospital, Melbourne, Victoria, Australia.
  • Varma D; Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia.
  • Fitzgerald J; Department of Paediatric Emergency Medicine, Children's Health Ireland at Temple Street, Dublin, Ireland.
  • Mitchell HJ; Department of Paediatric Radiology, Children's Health Ireland at Temple Street, Dublin, Ireland.
  • Teague WJ; Department of Paediatrics, Trinity College Dublin and the National Maternity Hospital, Dublin, Ireland.
Emerg Med Australas ; 35(3): 412-419, 2023 06.
Article en En | MEDLINE | ID: mdl-36418011
OBJECTIVE: Life-threatening thoracic trauma requires emergency pleural decompression and thoracostomy and chest drain insertion are core trauma procedures. Reliably determining a safe site for pleural decompression in children can be challenging. We assessed whether the Mid-Arm Point (MAP) technique, a procedural aid proposed for use with injured adults, would also identify a safe site for pleural decompression in children. METHODS: Children (0-18 years) attending four EDs were prospectively recruited. The MAP technique was performed, and chest wall skin marked bilaterally at the level of the MAP; no pleural decompression was performed. Radio-opaque markers were placed over the MAP-determined skin marks and corresponding intercostal space (ICS) reported using chest X-ray. RESULTS: A total of 392 children participated, and 712 markers sited using the MAP technique were analysed. Eighty-three percentage of markers were sited within the 'safe zone' for pleural decompression (4th to 6th ICSs). When sited outside the 'safe zone', MAP-determined markers were typically too caudal. However, if the site for pleural decompression was transposed one ICS cranially in children ≥4 years, the MAP technique performance improved significantly with 91% within the 'safe zone'. CONCLUSIONS: The MAP technique reliably determines a safe site for pleural decompression in children, albeit with an age-based adjustment, the Mid-Arm Point in PAEDiatrics (MAPPAED) rule: 'in children aged ≥4 years, use the MAP and go up one ICS to hit the safe zone. In children <4 years, use the MAP.' When together with this rule, the MAP technique will identify a site within the 'safe zone' in 9 out of 10 children.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neumotórax / Traumatismos Torácicos / Pared Torácica Límite: Adult / Child / Humans Idioma: En Revista: Emerg Med Australas Asunto de la revista: MEDICINA DE EMERGENCIA Año: 2023 Tipo del documento: Article País de afiliación: Irlanda Pais de publicación: Australia
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neumotórax / Traumatismos Torácicos / Pared Torácica Límite: Adult / Child / Humans Idioma: En Revista: Emerg Med Australas Asunto de la revista: MEDICINA DE EMERGENCIA Año: 2023 Tipo del documento: Article País de afiliación: Irlanda Pais de publicación: Australia