{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T22:58:48Z","timestamp":1784242728405,"version":"3.55.0"},"reference-count":13,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2021,6,4]],"date-time":"2021-06-04T00:00:00Z","timestamp":1622764800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Ultrasound Medicine"],"published-print":{"date-parts":[[2022,3]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>Thoracostomy is often a required treatment in patients with thoracic trauma; however, performing a thoracostomy using traditional techniques can have complications. Ultrasound can be a beneficial tool for identifying the correct thoracostomy insertion site. We designed a randomized prospective study to assess if ultrasound guidance can improve thoracostomy site identification over traditional techniques.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Emergency medicine residents were randomly assigned to use palpation or ultrasound to identify a safe insertion site for thoracostomy placement. The target population comprised of hemodynamically stable trauma patients who received an extended focused assessment with sonography for trauma (EFAST) and a chest computed tomography (CT) exam. The resident placed a radiopaque marker on the skin of the patient where a safe intercostal space was believed to be located, either by palpation or ultrasound. Clinical ultrasound faculty reviewed the CT to confirm marker placement relative to the diaphragm. A Fischer's exact test was used to analyze the groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>One hundred and forty\u2010seven patients were enrolled in the study, 75 in the ultrasound group and 72 in the landmark group. This resulted in the placement of 271 total thoracostomy site markers, 142 by ultrasound and 129 by palpation and landmarks. The ultrasound group correctly identified thoracostomy insertion sites above the diaphragm in 97.2% (138\/142) of patients, while the palpation group identified a safe insertion site in 88.4% (114\/129) of patients (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.0073).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study found that emergency medicine residents are more likely to identify a safe tube thoracostomy insertion site in trauma patients by using ultrasound, as compared to using landmarks and palpation.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jum.15759","type":"journal-article","created":{"date-parts":[[2021,6,4]],"date-time":"2021-06-04T18:57:24Z","timestamp":1622833044000},"page":"743-747","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Novel Approach to Ultrasound\u2010Guided Thoracostomy"],"prefix":"10.1002","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7397-8665","authenticated-orcid":false,"given":"Lindsay A.","family":"Taylor","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine Virginia Commonwealth University  Richmond Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Stenberg","sequence":"additional","affiliation":[{"name":"Cleveland Clinic  Akron Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0514-8576","authenticated-orcid":false,"given":"Jordan","family":"Tozer","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Virginia Commonwealth University  Richmond Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael J.","family":"Vitto","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Virginia Commonwealth University  Richmond Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Joyce","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Virginia Commonwealth University  Richmond Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason","family":"Jennings","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Virginia Commonwealth University  Richmond Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher L.","family":"Carpenter","sequence":"additional","affiliation":[{"name":"Henrico Doctors Forest  Richmond Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6899-0459","authenticated-orcid":false,"given":"Robert","family":"Fuchs","sequence":"additional","affiliation":[{"name":"School of Medicine, Virginia Commonwealth University  Richmond Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zachary","family":"Deuell","sequence":"additional","affiliation":[{"name":"School of Medicine, Virginia Commonwealth University  Richmond Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David P.","family":"Evans","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Virginia Commonwealth University  Richmond Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,6,4]]},"reference":[{"key":"e_1_2_8_2_1","unstructured":"Injury Center CDC.WISQARS (Web\u2010Based Injury Statistics Query and Reporting System);2017.https:\/\/www.cdc.gov\/injury\/wisqars\/index.html. Accessed 9 July 2019."},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.thorsurg.2007.02.004"},{"key":"e_1_2_8_4_1","volume-title":"Advanced Trauma Life Support Course for Doctors Instructor Course Manual","author":"American College of Surgeons, Committee on Trauma","year":"2004"},{"key":"e_1_2_8_5_1","first-page":"142","volume-title":"Great Books of the Western World","author":"Hutchins RM","year":"1952"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2008.08.006"},{"key":"e_1_2_8_7_1","first-page":"450","article-title":"Chest tube complications: how well are we training our residents?","volume":"50","author":"Ball CG","year":"2007","journal-title":"Can J Surg"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1155\/2012\/256878"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9610(80)90107-5"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1510\/icvts.2010.243196"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1136\/pgmj.2004.024752"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/1742-6723.12276"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/jcu.20884"},{"key":"e_1_2_8_14_1","article-title":"Ultrasound\u2010guided Thoracostomy site identification in healthy volunteers","volume":"10","author":"Taylor LA","year":"2018","journal-title":"Critic Ultrasound J"}],"container-title":["Journal of Ultrasound in Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jum.15759","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/jum.15759","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jum.15759","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,25]],"date-time":"2023-08-25T12:49:10Z","timestamp":1692967750000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jum.15759"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,6,4]]},"references-count":13,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2022,3]]}},"alternative-id":["10.1002\/jum.15759"],"URL":"https:\/\/doi.org\/10.1002\/jum.15759","archive":["Portico"],"relation":{},"ISSN":["0278-4297","1550-9613"],"issn-type":[{"value":"0278-4297","type":"print"},{"value":"1550-9613","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,6,4]]},"assertion":[{"value":"2020-12-09","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-05-16","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-06-04","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}