Wyoming Life Flight Adds Lifesaving Clinical Capability

Emergency air medical bases can now perform open thoracostomies

CASPER, WY, March 19, 2026 - Flight nurses with emergency air medical provider Wyoming Life Flight, located in Casper and Evanston, now have another option when treating patients suffering from a collapsed lung due to excess air or blood trapped in the chest cavity. If their traditional procedure, a needle thoracostomy, does not result in the lung reinflating, nurses are now trained to perform an open thoracostomy (also known as a finger thoracostomy). While more intrusive, this procedure is considered a more reliable method of addressing this life-threatening condition in a pre-hospital setting.

"Finger thoracostomy (FT) increases the survival rate of patients in prehospital settings by immediately relieving the pressure of air in the chest, known as a tension pneumothorax. Previously, we were able to use needle decompression. This method is often successful but also has limitations due to needle length or blockage," said Stephanie Smith, a flight nurse with Wyoming Life Flight. "In a traumatic arrest, FT has the ability to restore spontaneous circulation, which can increase the survival rate. FT also allows for safer drainage of the pleural space in the event of hemothorax (blood in the chest cavity) and can be performed quickly."

When pressure builds in the chest due to air or blood, it can not only collapse the lungs, but also compresses the heart, making it difficult to circulate oxygen around the body effectively. Having two proven methods for relieving this pressure gives flight nurses more options for helping patients survive chest trauma, frequently caused by motor vehicle accidents, falls, or other emergencies. With an open thoracostomy, the flight nurse makes a small incision between the ribs on the patient's side and inserts a finger to release the trapped air or blood. It allows more air/blood to escape, leading to a fuller reinflation of the lung, over a needle thoracostomy.

"Open thoracostomy is intended to optimize oxygenation and relieve pressure, particularly when needle thoracostomy has been unsuccessful or when transporting patients with known tension physiology without immediate access to a chest tube," said Air Methods Regional Clinical Director Teather Campbell. Wyoming Life Flight is part of Air Methods, the nation's leading air medical provider.

With both rotor and fixed wing aircraft, Wyoming Life Flight serves the entire state. Their clinicians have at least three years of experience in an emergency or intensive care setting before joining a flight crew, and they receive ongoing advanced training. Their aircraft are equipped as flying ICUs, carrying the medical equipment and medications needed to provide lifesaving care for trauma, cardiac, stroke, pediatric, neonatal, high-risk obstetrics, and other critical patients. Wyoming Life Flight recently added a TOCO fetal monitor to track critical vital signs of pregnant women and their babies during transport. They also carry a Zoll AutoPulse CPR device for in-flight mechanical CPR, as well as whole blood that can be administered in-flight for patients suffering from severe blood loss. The ability to perform open thoracostomies is another tool in their nurses' belts to provide the highest level of care when every minute counts.

"In our rural setting, a scene call can be over 30 minutes away from a hospital," said Smith. "This procedure can bridge the gap to definitive care, giving the patient a chance of survival they may not have otherwise had." Air Methods is committed to providing air medical services to all members of the communities they serve and are in-network with most major health insurance providers for emergency air medical services. Additionally, their patient advocacy program works with all patients, regardless of insurance, to ensure affordability without the need for an air medical membership.