TY - JOUR
T1 - Needle Thoracostomy
T2 - Implications of Computed Tomography Chest Wall Thickness
AU - Givens, Melissa L.
AU - Ayotte, Karen
AU - Manifold, Craig
PY - 2004/2
Y1 - 2004/2
N2 - Objectives: To determine the length of catheter required to perform a needle thoracostomy, as determined by chest wall thickness, to treat the majority of patients presenting to the emergency department (ED) with a potential tension pneumothorax. Methods: A convenience sample of 111 computed tomography (CT) scans of the chest in trauma and medical resuscitation patients at a military Level 1 trauma center in San Antonio, Texas, was pooled, and the chest wall thickness was measured at the second intercostal space, midclavicular line, to the nearest 0.1 cm. Results: The mean chest wall thickness in the patients studied averaged 4.24 cm (95% confidence interval [CI] = 3.97 to 4.52). Nearly one fourth (25) of the study patients had a chest wall thicker than 5 cm. Women, on average, have thicker chest walls than men (4.90 for women; 4.16 for men; p = 0.022). Conclusions: In this study, a catheter length of 5 cm would reliably penetrate the pleural space of only 75% of patients. A longer catheter should be considered, especially in women.
AB - Objectives: To determine the length of catheter required to perform a needle thoracostomy, as determined by chest wall thickness, to treat the majority of patients presenting to the emergency department (ED) with a potential tension pneumothorax. Methods: A convenience sample of 111 computed tomography (CT) scans of the chest in trauma and medical resuscitation patients at a military Level 1 trauma center in San Antonio, Texas, was pooled, and the chest wall thickness was measured at the second intercostal space, midclavicular line, to the nearest 0.1 cm. Results: The mean chest wall thickness in the patients studied averaged 4.24 cm (95% confidence interval [CI] = 3.97 to 4.52). Nearly one fourth (25) of the study patients had a chest wall thicker than 5 cm. Women, on average, have thicker chest walls than men (4.90 for women; 4.16 for men; p = 0.022). Conclusions: In this study, a catheter length of 5 cm would reliably penetrate the pleural space of only 75% of patients. A longer catheter should be considered, especially in women.
KW - Catheter
KW - Chest wall thickness
KW - Computed tomography
KW - Needle thoracostomy
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U2 - 10.1197/j.aem.2003.09.015
DO - 10.1197/j.aem.2003.09.015
M3 - Article
C2 - 14759970
AN - SCOPUS:0842282696
VL - 11
SP - 211
EP - 213
JO - Academic Emergency Medicine
JF - Academic Emergency Medicine
SN - 1069-6563
IS - 2
ER -