REBEL EM - April 19, 2021 - By Benjamin M Gerretsen
Paper: Azizi et al. Optimal anatomical location for needle chest decompression for tension pneumothorax. Injury 2021. [Link is HERE]
“Clinical Question: What is the CWT at ICS2-MCL and ICS4/5-AAL* in normal weight-, overweight- and obese patients using Point of Care Ultrasound (POCUS), and what is the theoretical success rates of ND for these locations based on standard catheter lengths?
Author Conclusion: “In overweight- and obese subjects, the chest wall is thicker in ICS4/5-AAL than in ICS2-MCL and theoretical chances of successful needle decompression of a tension pneumothorax are significantly higher in ICS2-MCL compared to ICS4/5-AAL.”
Clinical Take Home Point: In this heterogenous patient population, ICS2-MCL seems to be the preferred anatomical location for tension pneumothorax decompression for overweight- and obese subjects compared to the ICS4/5-AAL using standard large bore catheters (45 mm and 50 mm).”