Military Medicine, Vol. 172, December 2007
Advanced Trauma Life Support guidelines and combat casualty care doctrine recommend the use of needle thoracentesis (needle thoracostomy) for the emergency treatment of tension pneumothorax. Emergency situations require a reproducible, simple, and effective normal response for treatment of life-threatening pneumothorax. This study evaluated chest wall thickness in a forward-deployed tri-service population using a retrospective analysis of multidetector CT (MDCT)-assisted autopsies performed on combat casualties at the Armed Forces Institute of Pathology.
If needle thoracentesis is attempted with an angiocatheter or needle of insufficient length, the procedure will fail. Recommended procedures for needle thoracentesis to relieve tension pneumothorax should be adapted to reflect use of an angiocatheter or needle of sufficient length. A 3.25 inch angiocatheter would have reached the pleural space in 99% of the cases in this series.