{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T00:39:25Z","timestamp":1747183165505,"version":"3.40.5"},"reference-count":10,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2022,9,4]],"date-time":"2022-09-04T00:00:00Z","timestamp":1662249600000},"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":["ANZ Journal of Surgery"],"published-print":{"date-parts":[[2022,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Tube thoracostomy (TT) in trauma is lifesaving. A previous audit at Counties Manukau District Health Board (CMDHB), New Zealand, showed a 22% complication rate for trauma TT. Subsequently CMDHB introduced a procedural guideline to reduce complications. The Health and Disability Commission published a report concerning oversights in TT removal. This led us to evaluate complications, documentation and procedural monitoring to identify ways to improve patient safety.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>A 30\u2010month retrospective audit of patients presenting to CMDHB, with injuries which may require TT. Those who had a TT <jats:italic>in situ<\/jats:italic>, did not require a TT or whose presentation was not secondary to trauma were excluded.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>One hundred and forty\u2010three TTs were performed in one hundred and fifteen patients. About 87% had injuries secondary to blunt mechanism. Penetrating injuries were more likely to require TT (<jats:italic>P<\/jats:italic>\u00a0=\u20090.015). Non\u2010accidental injuries were more likely to need TT (<jats:italic>P<\/jats:italic>\u00a0=\u20090.025). The complication rate was 25.2%. TT prior to imaging had a 31% complication rate (<jats:italic>P<\/jats:italic>\u00a0&lt;\u20090.03). About 23% had no TT insertion note. 40% had no TT removal note. About 9% TT insertions had no tertiary information to identify the proceduralist and a complication rate of 46%. About 22% of insertions and 4% of removals documented consent. About 2% of insertions documented anticoagulation status. Interventional radiology had the best documentation of data points assessed (<jats:italic>P<\/jats:italic>\u00a0&lt;\u20090.0001). Post\u2010procedural monitoring recommendations were documented in 1% insertions and 11% removals.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The complication rate has not reduced despite introduction of a guideline. Procedural documentation and monitoring were inadequate, potentially impacting patient safety.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ans.17996","type":"journal-article","created":{"date-parts":[[2022,9,5]],"date-time":"2022-09-05T05:55:52Z","timestamp":1662357352000},"page":"2635-2640","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Tube thoracostomy for trauma at Counties Manukau District Health Board, Aotearoa New Zealand"],"prefix":"10.1111","volume":"92","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7267-9460","authenticated-orcid":false,"given":"Jennifer","family":"Scott","sequence":"first","affiliation":[{"name":"Department of General Surgery Counties Manukau District Health Board  Auckland New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christin","family":"Coomarasamy","sequence":"additional","affiliation":[{"name":"Department of General Surgery Counties Manukau District Health Board  Auckland New Zealand"},{"name":"Research &amp; Evaluation Office Ko Awatea, Te Whatu Ora Health NZ, Counties Manukau"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2744-1546","authenticated-orcid":false,"given":"Kevin","family":"Henshall","sequence":"additional","affiliation":[{"name":"Department of General Surgery Counties Manukau District Health Board  Auckland New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew D.","family":"MacCormick","sequence":"additional","affiliation":[{"name":"Department of General Surgery Counties Manukau District Health Board\/University of Auckland  Auckland New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,9,4]]},"reference":[{"key":"e_1_2_8_2_1","first-page":"18","article-title":"Early chest drain management in Trauma","volume":"1","author":"Balhorn J","year":"2016","journal-title":"Trauma Acute Care"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.thorsurg.2016.08.009"},{"key":"e_1_2_8_4_1","first-page":"e33","article-title":"Comparing the quality and complications of tube thoracostomy by emergency medicine and surgery residents; a cohort study","volume":"7","author":"Kashani P","year":"2019","journal-title":"Arch. Acad. Emerg. Med."},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jss.2019.01.012"},{"key":"e_1_2_8_6_1","doi-asserted-by":"crossref","first-page":"189","DOI":"10.4103\/IJCIIS.IJCIIS_98_19","article-title":"Complications following chest tube insertion pre\u2010and post\u2010implementation of guidelines in patients with chest trauma: a retrospective, observational study","volume":"10","author":"El\u2010Faramawy A","year":"2020","journal-title":"Int. J. Crit. Illn. Inj. Sci."},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjquality.u204172.w3891"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0000000000001840"},{"key":"e_1_2_8_9_1","unstructured":"Health and Disability Commissioner report case 18HDC01266. Available from URL:https:\/\/www.hdc.org.nz\/decisions\/search-decisions\/2021\/18hdc01266\/"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/ans.14327"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijsu.2018.07.002"}],"container-title":["ANZ Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ans.17996","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/ans.17996","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ans.17996","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,22]],"date-time":"2023-08-22T08:10:14Z","timestamp":1692691814000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ans.17996"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,9,4]]},"references-count":10,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2022,10]]}},"alternative-id":["10.1111\/ans.17996"],"URL":"https:\/\/doi.org\/10.1111\/ans.17996","archive":["Portico"],"relation":{},"ISSN":["1445-1433","1445-2197"],"issn-type":[{"type":"print","value":"1445-1433"},{"type":"electronic","value":"1445-2197"}],"subject":[],"published":{"date-parts":[[2022,9,4]]},"assertion":[{"value":"2022-01-25","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-08-08","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-09-04","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}