Needle decompression in tension pneumothorax: anterior or lateral approach?
Kilgour, Ian Baxter, John
Kilgour, Ian
Baxter, John
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Abstract
Background: For tension pneumothorax, the UK recommendation is to use a 14g, 5cm cannula to decompress the chest. Advice around site selection differs between using the second intercostal space (ICS) mid-clavicular line or the fifth
ICS near the mid-axillary line. The aim of this literature review is to determine the best approach for needle decompression using a standard 14g, 5cm cannula. Methods: A systematic search of multiple databases was conducted, using
inclusion and exclusion criteria. Outcomes were tabulated to identify any trends between various criteria including success with a 5cm cannula. Results: Thirty one studies were found, of which four were included. Mean chest wall thickness
was 35.8mm at the anterior site and 39.7mm at the lateral site. Overall success rates with a 5cm catheter were on average 79.7% at the anterior and 80% at the lateral position. Conclusion: There is no significant difference in success between
using the anterior or the lateral approach for needle decompression.
Abstract published with permission.