Flail Chest, Hemopneumothorax; Traumatic, Hemothorax, Pneumothorax, Thoracic Trauma
Conditions
Keywords
Underwater Seal System Alternatives, Chest Trauma, Improvised Chest Drainage, Nasogastric Tube Chest Drain, Low-Resource Trauma Care, Conflict Zone Healthcare, Pneumothorax Management, Hemothorax Treatment, Alternative Chest Tube Methods, Emergency Thoracic Intervention
Brief summary
This study examines the use of improvised chest drainage systems in managing chest trauma at Wad Madani Teaching Hospital, a low-resource and conflict-affected setting. Due to a shortage of standard chest tubes and underwater seal systems, healthcare providers have adapted by using nasogastric (NG) tubes as chest drains and IV drip sets as makeshift underwater seals. The study aims to evaluate the safety, effectiveness, and feasibility of these improvised methods compared to traditional chest drainage techniques. Primary outcomes will include lung re-expansion success, infection rates, and hospital stay length. By assessing patient outcomes, this study seeks to determine if these adapted techniques can provide a viable alternative for trauma care in resource-limited settings, potentially guiding practices in similar environments globally.
Detailed description
This study explores the application of improvised chest drainage systems at Wad Manani Teaching Hospital for managing chest trauma in a low-resource, conflict-affected setting. Due to limited availability of standard medical supplies, an alternative approach has been adopted using nasogastric (NG) tubes as chest drains paired with intravenous (IV) drip sets, modified to act as underwater seals. The primary aim is to assess the safety and effectiveness of these improvised systems in comparison to conventional chest tube drainage. By focusing on outcomes such as lung re-expansion success, infection rates, and recovery time, this study seeks to establish the clinical viability of improvised drainage systems in emergencies. Secondary evaluations include cost-effectiveness and the role of targeted staff training in improving procedural outcomes. Study Approach: This is a 6-months prospective observational study where patients with chest injuries are assigned to either a standard treatment group or an improvised treatment group. The improvised system involves inserting an NG tube as a chest drain connected to a modified IV drip set for underwater sealing. Standard sterile protocols are followed to reduce infection risk. Data Collection & Analysis: Data on each patient's clinical course and intervention will be recorded, focusing on primary outcomes like successful lung re-expansion and infection, and secondary outcomes, including procedural feasibility and cost. Comparative statistical analysis will assess outcome differences between groups. Ethical Compliance: Institutional review board (IRB) approval will be obtained, with all patient data anonymized and securely stored. Informed consent will be obtained from all participants or their guardians. Impact Statement: By assessing improvised methods in trauma care within a resource-limited context, this study could inform adaptable practices for similar environments worldwide, potentially influencing trauma care protocols and patient outcomes in challenging settings.
Interventions
None listed
Sponsors
Sudan Medical Specialization Board
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 70 Years
Healthy volunteers
No
Inclusion criteria
* Adults aged 18 years and older * Patients presenting with chest trauma requiring chest drainage (e.g., pneumothorax, hemothorax) * Willingness to provide informed consent to participate in the study -Stable enough to undergo chest X-ray or clinical assessment for lung re- expansion
Exclusion criteria
* Patients with pre-existing severe lung disease or significant comorbidities affecting chest drainage outcomes (e.g., advanced COPD, heart failure) * Patients with prior chest surgery that may interfere with drainage outcomes * Individuals with contraindications to chest tube insertion or NG tube placement * Patients unwilling or unable to provide informed consent
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Percentage of Patients With Successful Lung Re-expansion | Within 72 hours post-drainage | The percentage of patients in each group (conventional vs. improvised chest drainage) who achieve full lung re-expansion as confirmed by chest X-ray. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Rate of Drainage-Related Infections | Up to 30 days post-procedure | Number of participants with infections directly associated with the chest drainage procedure, including pleural or wound infections, documented by clinical signs and laboratory findings. |
| Median Length of Hospital Stay | From admission to discharge (typically within 30 days) | Median number of days from admission to discharge for each participant, allowing for the assessment of recovery duration associated with each drainage method. |
Other
| Measure | Time frame | Description |
|---|---|---|
| Patient Satisfaction Score at Discharge | At discharge (up to 30 days post-procedure) | Patient satisfaction score assessed using a 5-point Likert scale (1 = very dissatisfied, 5 = very satisfied) at discharge, indicating the participant's perceived comfort and effectiveness of the chest drainage method used. |
Countries
Sudan
Outcome results
None listed