Finger thoracostomy pilot project trains STARS teams to perform life-saving procedure

In the world of critical care, the medical experts at STARS are always looking for new opportunities to save lives. Innovations like ultrasound and blood on board our aircraft have made a real difference for patients. Now, another life-saving tool is being trialed by STARS.

Thoracostomy is a potentially life-saving procedure used to relieve tension pneumothorax — a buildup of air in the cavity between the lungs and the chest wall. This condition, which can develop in severely injured patients, causes the lung to collapse, putting pressure on the heart and other vital organs. Without prompt intervention, this condition can lead to cardiac arrest and even death.

Historically, “needle thoracostomy” was used by paramedics to relieve the pressure in this life-threatening circumstance. However, current evidence suggests that needle thoracostomy is not always successful. A better solution was needed. For this reason, a small group of nurse and paramedic air medical crew members have now been trained to use the more definitive procedure, which is called “finger thoracostomy.”

Identical to the way it would be performed by a surgeon in a hospital, the procedure involves making a small incision to allow for the insertion of a gloved finger, followed by a sweep of the finger in the chest cavity, allowing the air to escape and the pressure on vital organs to be relieved.

“In addition to its speed and ease of use, the main benefit of finger thoracostomy is that it definitively addresses the problem of increased pressure in the chest,” explained Dr. Doug Martin, STARS medical director for Manitoba. “The crew can also proceed to insert a chest tube, in order to ensure that the problem does not recur during transport. This can absolutely be life-saving for a critically injured patient.”

Launched in the summer of 2023, this pilot project provided a group of STARS nurses and paramedics in Manitoba with physician-led training on how to perform finger thoracostomies as well as the more traditional chest tube thoracostomies. Trained STARS medical crews have since performed both procedures on severely injured patients.

As part of STARS’ commitment to innovation, the results of this pilot project will be evaluated with the possibility of expanding training for thoracostomy procedures to additional STARS bases and medical crew members.

“Looking critically at our care and identifying ways to make it more effective is central to our mission at STARS,” added Dr. Martin. “If this procedure helps even a few people survive their injuries, that’s more than enough reason to invest in being able to provide it.”