Use of an endotracheal tube for a thoracostomy in a child in cardiac arrest: A case report

Abstract

Background: Traditionally when patients arrive at an Emergency Department in cardiac arrest with a concern for a pneumothorax, a thoracostomy tube is placed for decompression. In a literature review, there are no case reports of an endotracheal tube being used in lieu of a thoracostomy tube for a pneumothorax in a child in cardiac arrest.Case Presentation: We present a case of a 4-week-old female infant who presented to the Emergency Department in cardiac arrest with a pneumothorax.Why should an emergency physician be aware of this?: It is important for clinicians to be aware of alternative management strategies for the management of a pneumothorax. Our case suggests that an endotracheal tube being used as a thoracostomy tube in a child in cardiac arrest can help acutely treat a pneumothorax by providing immediate and continuous decompression. In a prehospital or low-resource setting, an endotracheal tube may offer similar benefits to a thoracostomy tube as an immediate treatment modality.