I think it's well understood that anyone with a tension pneumothorax needs decompression, and definitive treatment is a chest thoracostomy. There's also the life-saving intervention of the needle thoracostomy; take a 14G angiocath, 2nd ICS, mid-clavicular line, and "pssshhhtt". The lung inflates, and you save Mark Wahlberg's life (click below in case I lost you):
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| Warner Bros. |
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Well turns out the 2nd ICS may not be the most reliable position. There have been multiple studies in
Japan,
Turkey,
Netherlands, and
US that have found the 5th ICS place has a better chance of penetrating the chest cavity. Also, the larger your BMI, the less likely a angiocath can make it into the chest cavity. Although...I think it's a fair trade-off, who wants to be cold all the time?
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| Matt McAllister is my hero |
Check out
Dr. Michelle Lin's blog for more info:
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