Intercostal Space Guide Supports Emergency Thoracostomies

An innovative device improves the accuracy of lateral decompression needle and chest tube placement during thoracostomy procedures.

The SAM Medical (Wilsonville, OR, USA) ThoraSite is an anatomical landmark guide that is designed to provide a safer approach to the pleural space during emergency procedures, such as the treatment of collapsed lungs and chest wounds following pneumothorax, hemothorax, and similar conditions. In such emergency situations, field providers often consume valuable time counting ribs to identify the appropriate intercostal space for a lateral thoracostomy. The ThoraSite aids them by referencing the patient's own anatomical landmarks to position a Safe Zone Window (SZW) directly over the ideal procedure site.


The disposable guide uses two known axes in order to orient itself to a perpendicular intersection point above the intercostal area; the first axis positions the ThoraSite accurately between the anterior axillary and midaxillary line, while the second axis aligns the window over the 3rd, 4th, or 5th intercostal space. An arrow aligns the guide with the anterior iliac crest/hip, while an axilla hook aligns it along the anterior axillary line/midaxillary axis. The dual-sided laminated device is also optimized for low-light conditions, compatible with night vision devices, and suitable for X-rays imaging.

“In time sensitive situations there needs to be a simplified, efficient solution to identify the appropriate intercostal spaces and simplify the cognitive burden associated with thoracostomies,” commented Sam Scheinberg, MD, founder and CEO of SAM Medical. “ThoraSite was developed to address this problem. THoraSite reduces procedure time by quickly facilitating procedure site location, increases likelihood of appropriate needle/tube placement, and decreases iatrogenic injury.”

An estimated 50,000 injuries per year and one in four trauma deaths is directly the result of thoracic injuries, with thoracic trauma is a contributing factor in another 25% of trauma patients who die of their injuries. Correctly performed lateral emergency needle thoracostomies, which are commonly performed in the prehospital and emergency department setting, could help reduce this mortality rate.

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