Jurnal Internasional Afrika vol. 9 issue 2 2019
African Journal of Emergency Medicine
Pre-hospital intercostal chest drains in South Africa: A modified Delphi study
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Title
Jurnal Internasional Afrika vol. 9 issue 2 2019
African Journal of Emergency Medicine
Pre-hospital intercostal chest drains in South Africa: A modified Delphi study
African Journal of Emergency Medicine
Pre-hospital intercostal chest drains in South Africa: A modified Delphi study
Subject
Pre-hospital
Intercostal chest drain
Pneumothorax
Haemothorax
Intercostal chest drain
Pneumothorax
Haemothorax
Description
Introduction: Trauma is one of the most common causes of death in low- and middle-income countries, with
thoracic injury accounting for 20–25% of these deaths worldwide. The current management of a life-threatening
pre-hospital pneumothorax is with a needle chest decompression, however, definitive care for a pneumothorax
and/or haemothorax is still the insertion of an intercostal chest drain. The aim of this study was to seek expert
opinion and consensus on the placement of ICDs in the pre-hospital emergency care setting in South Africa.
Methods: A three-round modified Delphi study was undertaken with an expert panel drawn from local emergency
care experts consisting of physicians and emergency medical service practitioners. Participants supplied
opinion statements in round 1 under headings derived from common emerging themes found in the literature.
During round 2 participants used a 9-point Likert scale to rate their consensus on each statement and in round 3
they were able to change their position based on the earlier panel distributions. A consensus percentage of 60%
was set within a narrow margin of ‘strongly agree’ or ‘strongly disagree’.
Results: A total of 22 experts took part as panel members. There were 123 opinion statements produced from
round 1, of which 21 (17%) reached consensus in round 2. At the end of round 3 another four statements reached
consensus, bringing the total up to 25 (20%).
Conclusion: Definitive care of a life-threating pneumothorax and/or haemothorax must be sought emergently.
The insertion of an ICD, under select conditions, may be required in the pre-hospital setting in South Africa
thoracic injury accounting for 20–25% of these deaths worldwide. The current management of a life-threatening
pre-hospital pneumothorax is with a needle chest decompression, however, definitive care for a pneumothorax
and/or haemothorax is still the insertion of an intercostal chest drain. The aim of this study was to seek expert
opinion and consensus on the placement of ICDs in the pre-hospital emergency care setting in South Africa.
Methods: A three-round modified Delphi study was undertaken with an expert panel drawn from local emergency
care experts consisting of physicians and emergency medical service practitioners. Participants supplied
opinion statements in round 1 under headings derived from common emerging themes found in the literature.
During round 2 participants used a 9-point Likert scale to rate their consensus on each statement and in round 3
they were able to change their position based on the earlier panel distributions. A consensus percentage of 60%
was set within a narrow margin of ‘strongly agree’ or ‘strongly disagree’.
Results: A total of 22 experts took part as panel members. There were 123 opinion statements produced from
round 1, of which 21 (17%) reached consensus in round 2. At the end of round 3 another four statements reached
consensus, bringing the total up to 25 (20%).
Conclusion: Definitive care of a life-threating pneumothorax and/or haemothorax must be sought emergently.
The insertion of an ICD, under select conditions, may be required in the pre-hospital setting in South Africa
Creator
Enrico Dippenaar, Lee Wallis
Source
www.elsevier.com/locate/afjem
Date
4 January 2019
Contributor
peri irawan
Format
pdf
Language
english
Type
text
Files
Citation
Enrico Dippenaar, Lee Wallis, “Jurnal Internasional Afrika vol. 9 issue 2 2019
African Journal of Emergency Medicine
Pre-hospital intercostal chest drains in South Africa: A modified Delphi study,” Repository Horizon University Indonesia, accessed March 13, 2025, https://repository.horizon.ac.id/items/show/2385.
African Journal of Emergency Medicine
Pre-hospital intercostal chest drains in South Africa: A modified Delphi study,” Repository Horizon University Indonesia, accessed March 13, 2025, https://repository.horizon.ac.id/items/show/2385.