Abstract IS A CHEST TUBE NECESSARY PRIOR TO AIR MEDICAL TRANSPORT OF

Objective: It is conventionally thought that patients with pneumothoraces (PTX) require tube thoracostomy prior to air medical transport (AMT), especially in un-pressurized rotor-wing aircraft, to prevent deterioration from expansion of the pneumothorax and possible development of tension pneumothorax. We hypothesized that patients with pneumothorax(ces) transported without prior tube thoracostomy tolerate AMT without serious deterioration. Methods: We conducted a retrospective case-series of trauma patients transported via helicopter with radiographically confirmed PTX between September 2002 and September 2005. Charts were evaluated for signs of deterioration including hypotension, hypoxemia, respiratory distress, intubation, needle thoracostomy or cardiac arrest during transport. In addition, duration of flight and altitude change was recorded. Results: During the study period, 55 patients with confirmed PTX underwent rotor-wing AMT with an average altitude gain of 1950 feet and average duration of 22 minutes (range 3 to 70). 12 of 55 (22%) were transported between hospitals with the remainder (43/55, 88%) coming from scenes or small clinics. 37 of 55 PTX (67%) were suspecte