{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:41:50Z","timestamp":1787013710686,"version":"build-2736575974"},"reference-count":15,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2019,4,30]],"date-time":"2019-04-30T00:00:00Z","timestamp":1556582400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100011302","name":"Children\u2019s Hospital Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100011302","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Emerg Medicine Australasia"],"published-print":{"date-parts":[[2019,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>The intersecting scenarios of multi\u2010trauma, thoracic injury and traumatic cardiac arrest present some of the most demanding moments in paediatric trauma. For these reasons, decision support through teamwork, checklists, technology and guidelines are central to ensuring quality paediatric trauma care. The \u2018Rule of 4's\u2019 is a simple aide\u2010memoire, which guides clinicians of all grades, expertise and distractedness in a reliable approach to injured children who require safe and effective emergency pleural decompression and timely insertion of a chest drain. The Rule of 4\u2019s enables these important therapeutic goals to be met through: (i) four steps in a \u2018good plan\u2019; (ii) fourth (or fifth) intercostal space as the basis for siting a \u2018good hole\u2019; (iii) 4\u00d7 uncuffed endotracheal tube size (4\u00d7 [age\/4\u2009+\u20094]) to guide selection of a \u2018good tube\u2019; and (iv) 4 cm mark for a \u2018good stop\u2019 to ensure the drain is in far enough but not too far.<\/jats:p>","DOI":"10.1111\/1742-6723.13299","type":"journal-article","created":{"date-parts":[[2019,4,30]],"date-time":"2019-04-30T23:35:48Z","timestamp":1556667348000},"page":"683-687","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Rule of 4\u2019s: Safe and effective pleural decompression and chest drain insertion in severely injured children"],"prefix":"10.1111","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4747-6025","authenticated-orcid":false,"given":"Warwick J","family":"Teague","sequence":"first","affiliation":[{"name":"Trauma Service The Royal Children's Hospital Melbourne Victoria Australia"},{"name":"Department of Paediatric Surgery The Royal Children's Hospital Melbourne Victoria Australia"},{"name":"Surgical Research Murdoch Children's Research Institute Melbourne Victoria Australia"},{"name":"Department of Paediatrics The University of Melbourne Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keith V","family":"Amarakone","sequence":"additional","affiliation":[{"name":"Trauma Service The Royal Children's Hospital Melbourne Victoria Australia"},{"name":"Department of Emergency Medicine The Royal Children's Hospital Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7725-7678","authenticated-orcid":false,"given":"Nuala","family":"Quinn","sequence":"additional","affiliation":[{"name":"Trauma Service The Royal Children's Hospital Melbourne Victoria Australia"},{"name":"Department of Emergency Medicine The Royal Children's Hospital Melbourne Victoria Australia"},{"name":"Emergency Research Murdoch Children's Research Institute Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,4,30]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/aas.12207"},{"key":"e_1_2_9_3_1","volume-title":"Top Knife: The Art and Craft of Trauma Surgery","author":"Hirshberg A","year":"2005"},{"key":"e_1_2_9_4_1","first-page":"3","article-title":"Identifying a safe site for intercostal catheter insertion using the mid\u2010arm point (MAP)","volume":"2017","author":"Bing F","year":"2017","journal-title":"JEMTAC"},{"key":"e_1_2_9_5_1","first-page":"417","article-title":"BET1: pre\u2010hospital finger thoracostomy in patients with traumatic cardiac arrest","volume":"34","author":"Jodie P","year":"2017","journal-title":"Emerg. 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[Cited 11 Jan 2019.] Available from URL:https:\/\/resus.org.au\/wpfb\u2010file\/anzcor\u2010guideline\u201011\u201010\u20101\u2010als\u2010traumatic\u2010arrest\u201027apr16\u2010pdf\/"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2014.05.013"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.anes.0000267594.80368.01"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1136\/pgmj.2004.024752"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1308\/003588414X14055925058599"},{"key":"e_1_2_9_12_1","unstructured":"National Clinical Guideline Centre.Major Trauma: Assessment and Management of Major Trauma (NICE Guideline NG39: Methods Evidence and Recommendations). National Institute for Health and Care Excellence 2016. 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