top of page

CoMiTED – Conservative Management in Traumatic Pneumothoraces in the Emergency Department (CoMiTED)

We are very close to opening the COMiTED study, initially at TW and then Maidstone. COMiTED is an RCT involving traumatic pneumothoraxes’ and the use of chest drains.

Previous Research

An international survey of senior emergency clinicians (222 respondents from 5 different countries) highlighted variation in clinical practice, involving both conservative and invasive management, for patients presenting with moderate to severe traumatic pneumothoraces. This indicates a level of uncertainty around the need for chest drain insertion in this patient population, and clinical equipoise to support conduction of CoMiTED.

Data from the Trauma Audit and Research Network database for over 600 patients presenting to a UK major trauma centre with traumatic pneumothorax/ces (2012-2016) was analysed in this large retrospective observational study. 46% of patients were initially treated with conservative management, including 62 patients receiving immediate positive pressure ventilation. 90% of those managed conservatively did not require subsequent chest drain insertion. Recommendations were for prospective randomised trial(s) to establish outcomes of conservative management for patients with traumatic pneumothorax in which clinicians do not believe an immediate chest drain is warranted.

Please see attached and below some important information about the study:

Training modules:

If you wish to consent patients you will need your GCP and training modules 1 ,3 ,7.

Those who attended the ACP study day have already completed modules 1 and 3.

Clinicians who will only be assessing patients as suitable need to complete module 7.

To randomise you will need to complete 1,3, 4, 7.

All guidance on which modules you should complete are on the website.

You can access the training here: CoMiTED – Conservative Management in Traumatic Pneumothoraces in the Emergency Department (CoMiTED): A Randomised Controlled Trial ( the password is comited. There is a QR code at the end to scan to say you have completed.

You will also need a GCP and Research CV, Good Clinical Practice (GCP) | NIHR You need to make an account and then take the GCP course lasting 3-4 hours. Please find attached the Research CV, please sign and scan this back to us .

There is a short patient information video which gives a good overview of the study: Information For Patients – CoMiTED (

As this will run 24 hours a day as many as possible who are able to consent, randomise patients, assess suitability for this study to be successful at MTW. These patients aren’t the most common to present, so we need to have as many people as possible to be able to identify potential participants and to consent them.

For those completing portfolios the study centre will issue certificates of research activity/participation when you have completed training.

It would be fantastic to have you all participating in this study. If you have any questions then please ask or email , Anna or Roshin who is the PI for this study.

See below for more information regarding the study

CoMiTED Flow sheet
Download PDF • 1.06MB

CoMiTED Poster
Download DOCX • 324KB

CoMiTED Staff Guidance
Download DOCX • 248KB

CoMiTED Patient Summary Sheet
Download DOCX • 538KB


bottom of page