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Thoracic lavage
From WikEM
Background
- Active internal re-warming for hypothermic patients
- Avoid left sided tubes in a perfusing patient since the heart is irritable.
- Consider in
- Severe Hypothermia
- Cardiovascular instability / life-threatening dysrhythmias
- Moderate hypothermia which fails to respond to less aggressive measures
One Tube System
- Single Lateral Thoracostomy Tube
- Introduce large bolus of warmed saline
- Allow fluid to sit for 15-20 mins and then drain
Two Tube System
- Anterior Tube
- Site at 2nd-3rd intercostal space at the midclavicular line
- Attach to a high rate infuser at 40-45°C
- Infuse 200 to 300mL
- This tube can be a pigtail
- Lateral Tube
- 4-6th Intercostal space at post-axillary line
- Attach to continuous drainage via pleur-evac or auto-transfuser (if using autotranfuser can re-attach to warming line for closed circuit)
See Also
References
Authors
Justin Arndt, Lisa Yee, Ross Donaldson, Michael Holtz, Daniel Ostermayer
