Use of an Endotracheal Tube for a Thoracostomy in a Child in Cardiac Arrest: A Case Report

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. A literature review found 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 Report: A case of a 4-week-old female infant who presented to the emergency department in cardiac arrest with a pneumothorax is discussed. 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. This 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 benefits similar to a thoracostomy tube as an immediate treatment modality.