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{
    "pk": 19123,
    "title": "Sonographic Identification of Tube Thoracostomy Study (SITTS): Confirmation of Intrathoracic Placement",
    "subtitle": null,
    "abstract": "Introduction: Thoracostomy tubes (TT) are commonly placed in the management of surgical, emergency, and trauma patients and chest radiographs (CXR) and computed tomography (CT) are performed to confirm placement. Ultrasound (US) has not previously been used as a means to confirm intrathoracic placement of chest tubes. This study involves a novel application of US to demonstrate chest tubes passing through the pleural line, thus confirming intrathoracic placement.\nMethods: This was an observational proof-of-concept study using a convenience sample of patients with TTs at a tertiary-care university hospital. Bedside US was performed by the primary investigatorusing first the low-frequency (5–1 MHz) followed by the high-frequency (10–5 MHz) transducers, in both 2-dimensional gray-scale and M-modes in a uniform manner. The TTs were identified in transverse and longitudinal views by starting at the skin entry point and scanning to where the TT passed the pleural line, entering the intrathoracic region. All US images were reviewed by US fellowship-trained emergency physicians. CXRs and CTs were used as the standard for confirmation ofTT placement.\nResults: Seventeen patients with a total of 21 TTs were enrolled. TTs were visualized entering the intrathoracic space in 100% of cases. They were subjectively best visualized with the high-frequency (10–5 MHz) linear transducer. Sixteen TTs were evaluated using M-mode. TTs produced a distinct pattern on M-mode.\nConclusion: Bedside US can visualize the TT and its entrance into the thoracic cavity and it can distinguish it from the pleural line by a characteristic M-mode pattern. This is best visualized with the high-frequency (10–5 MHz) linear transducer. [West J Emerg Med. 2012;13(4):305–311.]",
    "language": "en",
    "license": {
        "name": "Creative Commons Attribution-NonCommercial  4.0",
        "short_name": "CC BY-NC 4.0",
        "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNonCommercial — You may not use the material for commercial purposes.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.",
        "url": "https://creativecommons.org/licenses/by-nc/4.0"
    },
    "keywords": [
        {
            "word": "bedside ultrasound"
        },
        {
            "word": "chest tube placement"
        },
        {
            "word": "procedure"
        },
        {
            "word": "Emergency Medicine"
        }
    ],
    "section": "Ultrasound",
    "is_remote": true,
    "remote_url": "https://escholarship.org/uc/item/5r57s0kq",
    "frozenauthors": [
        {
            "first_name": "Jamie",
            "middle_name": "A",
            "last_name": "Jenkins",
            "name_suffix": "",
            "institution": "Stanford University/Kaiser Permanente Emergency Medicine Residency Program,\nDivision of Emergency Medicine, Department of Surgery, Palo Alto, California",
            "department": "None"
        },
        {
            "first_name": "Laleh",
            "middle_name": "",
            "last_name": "Gharahbaghian",
            "name_suffix": "",
            "institution": "Stanford University Medical Center",
            "department": "None"
        },
        {
            "first_name": "Stephanie",
            "middle_name": "J",
            "last_name": "Doniger",
            "name_suffix": "",
            "institution": "Children’s Hospital and Research Center, Oakland Division of Emergency Medicine,\nOakland, California",
            "department": "None"
        },
        {
            "first_name": "Scott",
            "middle_name": "",
            "last_name": "Bradley",
            "name_suffix": "",
            "institution": "Stanford University/Kaiser Permanente Emergency Medicine Residency Program,\nDivision of Emergency Medicine, Department of Surgery, Palo Alto, California",
            "department": "None"
        },
        {
            "first_name": "Steve",
            "middle_name": "",
            "last_name": "Crandall",
            "name_suffix": "",
            "institution": "Stanford University School of Medicine Division of Emergency Medicine, Department\nof Surgery, Palo Alto, California",
            "department": "None"
        },
        {
            "first_name": "David",
            "middle_name": "A",
            "last_name": "Spain",
            "name_suffix": "",
            "institution": "Stanford University, Trauma/Critical Care Surgery, Department of Surgery, Palo Alto,\nCalifornia",
            "department": "None"
        },
        {
            "first_name": "Sarah",
            "middle_name": "R",
            "last_name": "Williams",
            "name_suffix": "",
            "institution": "Stanford University/Kaiser Permanente Emergency Medicine Residency Program,\nStanford Emergency Medicine Ultrasound Program and Fellowship Division of\nEmergency Medicine, Department of Surgery, Palo Alto, California",
            "department": "None"
        }
    ],
    "date_submitted": "2010-12-01T04:19:56Z",
    "date_accepted": "2010-12-01T04:19:56Z",
    "date_published": "2012-09-07T07:00:00Z",
    "render_galley": null,
    "galleys": [
        {
            "label": "",
            "type": "pdf",
            "path": "https://journalpub.escholarship.org/westjem/article/19123/galley/9485/download/"
        }
    ]
}