Needle Thoracostomy: Implications of Computed Tomography Chest Wall Thickness

Melissa L. Givens, Karen Ayotte, Craig Manifold

Research output: Contribution to journalArticlepeer-review

69 Scopus citations


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.

Original languageEnglish (US)
Pages (from-to)211-213
Number of pages3
JournalAcademic Emergency Medicine
Issue number2
StatePublished - Feb 2004
Externally publishedYes


  • Catheter
  • Chest wall thickness
  • Computed tomography
  • Needle thoracostomy

ASJC Scopus subject areas

  • Emergency Medicine


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