Open pneumothorax: the spectrum and outcome of management based on Advanced XXXX Life Support recommendations.

@entity1 @entity4045 @entity130
INTRODUCTION: The current management of open pneumothorax (OPTX) is based on Advanced @entity130 Life Support (ATLS) recommendations and consists of the application of a three-way occlusive dressing, followed by intercostal chest drain insertion. Very little is known regarding the spectrum and outcome of this approach, especially in the civilian setting. MATERIALS AND METHODS: We conducted a retrospective review of 58 consecutive @entity1 with OPTX over a four-year period managed in a high volume metropolitan trauma service in South Africa. RESULTS: Of the 58 @entity1 included, 95  % (55/58) were male, and the mean age for all @entity1 was 21  years. Ninety-seven percent of all @entity130 were inflicted by knives and the remaining 3  % (2/58) of @entity130 were inflicted by unknown weapons. 59  % of @entity130 were left sided. In six @entity1 (10  %) a protocol violation was present in their management. Five of the six @entity1 (83  %) in whom protocol violation occurred developed a life-threatening event (tension @entity4045 ) compared to none amongst those where the protocol was followed (p  <  0.001). There was no mortality as a direct result of management of OPTX following ATLS recommendations. CONCLUSIONS: ATLS recommendations for OPTX are safe and effective. Any deviation from this standard practice is associated with avoidable morbidity and potential mortality.
