Needle Decompression Failure

Article:

Chest Wall Thickness and Decompression Failure:  A Systematic Review and Meta-Analysis Comparing Anatomic Locations in Needle Thoracotomy. Injury 2015

Idea:

Meta analysis of trials assessing chest wall thickness as well as the success rates of needle thoracotomy at different anatomical sites on chest wall.

Study:

15 studies studying chest wall thickness.

13 studies studying effectiveness of needle thoracotomy by anatomical site with 5cm angiocath.

Findings:

Chest wall thickness is least at the 4/5th intercostal space in the anterior axillary line

The failure rate was least for needle insertion when using the 4/5th intercostal space in the anterior axillary line.

Takeaways:

Consider using the 4/5th intercostal space in the anterior axillary line when needle decompressing, as it is thinner than the 2nd intercostal mid axillary and has a lower failure rate.

#Trauma