Chest Injury Survivors Needed: Share your Story

Seeking Patient Volunteers to help support an NHS research project in chest injuries

Conservative Management in Traumatic Pneumothoraces in the Emergency Department (CoMiT-ED): A Randomised Controlled Trial

We are seeking patient volunteers to contribute to a project about Chest Injuries.

This project has been developed with the University of Bristol and Southmead Major Trauma Centre and is being led by Edward Carlton and Jonathan Benger who are both senior emergency medicine doctors in the NHS.

The project has been funded by the NHS in order to potentially improve care for victims of trauma who suffer lung collapse.

Patient volunteers will be required to attend 2-3 meetings (remotely) each year for three years and comment on paperwork involved in the trial.

Those taking part will be reimbursed fully for their time in the form of vouchers.

We are particularly interested in seeking representation from patients who have experienced multiple injuries (including chest injuries) and received a chest drain as part of their care (although this is not a definite requirement).

If you wish to get involved in this project please contact:

Ed.carlton@nbt.nhs.uk

Mobile: 07595040112

Project summary

Aims

We aim to find out whether victims of trauma who have lung collapse can be treated safely and effectively without the need to immediately insert a tube (chest drain) into their chest.

Background

Lung collapse is common following knife crime, falls or motor vehicle accidents. For years doctors have treated moderate or severe lung collapse in trauma victims by cutting a hole in the chest and inserting a tube (chest drain) to allow the lung to re-expand. Every year over 2000 chest drains are inserted into patients after trauma across the UK. This procedure is usually done without a general anaesthetic and is painful. The tube can lead to infection, scarring of the chest and long-term pain. Patients we have spoken to find chest drains uncomfortable and inconvenient as they stay in the chest for a few days at least. Previous research suggests that more patients could be treated safely without a chest drain. However, we now need to understand whether treatment without a chest drain works safely and effectively in practice, and is acceptable to patients.

Design and methods

We aim to study around 700 victims of trauma, aged 16 and above, who have lung collapse and are admitted to 30 hospital Emergency Departments across the England and Wales. After a scan or X-ray to diagnose the lung collapse, patients will be put into one of two groups by chance (randomisation) only if the treating doctors are uncertain as to whether a chest drain is needed or not. The first group will be treated in the usual way by having a chest tube inserted whilst in the Emergency Department. The second group will be carefully monitored on a hospital ward without an immediate chest drain. We will collect information from both groups to see if they need further procedures (including a chest drain or reinsertion) to treat their lung collapse in the first 30 days after injury or develop problems with breathing, pain and their general health up to six months later. We will interview some patients to understand the experiences of being treated with or without a chest drain and we will also investigate which approach to trauma management optimises NHS resources.

Patient and public involvement

We recognise that chest injuries affect a diverse range of people with different health needs. We have identified three broad groups this research is aimed at; young victims of knife crime, older frailer patients who suffer chest injuries after a fall and patients who suffer multiple injuries following major accidents like a car crash. We have sought the advice of individuals and groups in each of these categories to help design this research. Individuals representing each group will continue to be part of our Patient Advisory Group throughout the trial to ensure that the research is acceptable and relevant to patients.

Dissemination

If we find treating lung collapse without a chest drain is safe, effective and acceptable to patients, this could lead to widespread improvements in patient care across the NHS by reducing the need for a painful and risky procedure. Results will be published in scientific journals, we will present results at clinical conferences and make a short film with the help of patients involved in the trial to let clinicians know about the findings. Our patient groups will help us decide the best way to let patients know about the study results, including newsletters, social and traditional media.

Published 28th September 2021

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