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. 2020 Apr 30;5(1):e000498.
doi: 10.1136/tsaco-2020-000498. eCollection 2020.

Tube thoracostomy during the COVID-19 pandemic: guidance and recommendations from the AAST Acute Care Surgery and Critical Care Committees

Fredric M Pieracci  1 , Clay Cothren Burlew  1 , David Spain  2 , David H Livingston  3 , Eileen M Bulger  4 , Kimberly A Davis  5 , Christopher Michetti  6
Affiliations

Tube thoracostomy during the COVID-19 pandemic: guidance and recommendations from the AAST Acute Care Surgery and Critical Care Committees

Fredric M Pieracci et al. Trauma Surg Acute Care Open. .

Abstract

This document provides guidance for trauma and acute care surgeons surrounding the placement, management and removal of chest tubes during the COVID-19 pandemic.

Keywords: Hemothorax; guideline; hemopneumothorax; pneumothorax.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Denver Health Medical Center algorithm for thoracic surgery/procedures during COVID-19. EDT, emergency department thoracotomy; PAPR, powered air purifying respirator; PPE, personal protective equipment; PTX/HTX, pneumothorax/hemothorax.
Figure 2
Figure 2
Bleach may be added to the water seal chamber of the drainage system (orange arrow) instead of water alone.
Figure 3
Figure 3
In line viral filter applied to chest tube drainage system while on suction. Pictured is the BILF150 Multi-use in-line Filter (Buffalo Filter LLC, Lancaster, New York, USA) with two sections of additional suction tubing attached.
Figure 4
Figure 4
Gravity bag-based viral filter (pictured is the LaproShield Plus, Pall Medical, Port Washington, New York, USA) (A); attached to drainage system suction port while on water seal (B). Note that the lure lock has been cut-off so that the filter tubing may fit into the suction port of the drainage system.
Figure 5
Figure 5
Cable tie and gun (A); two cable ties allow easy visualization of the connection with complete assurance that the connection will not be dislodged (B).
See this image and copyright information in PMC

References

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