Chest Wall Thickness in Military Personnel - Implications for Needle Thoracentesis in Tension Pneumothorax
Source: Military Medicine, Volume 172, Number 12, December 2007 , pp. 1260-1263(4)
Abstract:Needle thoracentesis is an emergency procedure to relieve tension pneumothorax. Published recommendations suggest use of angiocatheters or needles in the 5-cm range for emergency treatment. Multidetector computed tomography scans from 100 virtual autopsy cases were used to determine chest wall thickness in deployed male military personnel. Measurement was made in the second right intercostal space at the midclavicular line. The mean horizontal thickness was 5.36 cm (SD = 1.19 cm) with angled (perpendicular) thickness slightly less with a mean of 4.86 cm (SD 1.10 cm). Thickness was generally greater than previously reported. An 8-cm angiocatheter would have reached the pleural space in 99% of subjects in this series. Recommended procedures for needle thoracentesis to relieve tension pneumothorax should be adapted to reflect use of an angiocatheter or needle of sufficient length.
Document Type: Research Article
Affiliations: 1: Carson Center for Mortuary Affairs, Dover, DE 19902. 2: Office of the Armed Forces Medical Examiner, Armed Forces Institute of Pathology, 1413 Research Boulevard, Rockville, MD 20850. 3: Current address: Department of Radiology and Radiological Sciences, Uniformed Services University of the Health Sciences, Bethesda, MD 20814. 4: Department of Radiologic Pathology, Armed Forces Institute of Pathology, 6825 16th Street, NW, Washington, DC 20306.
Publication date: December 2007
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Military Medicine is the Association's official monthly journal. The objective of the Journal is to promote awareness of Federal medicine by providing a forum for responsible discussion of common ideas and problems relevant to Federal healthcare. Its mission is: To increase healthcare education by providing scientific and other information to its readers; to facilitate communication; and to offer a prestige publication for members' writings.
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