UMEM Educational Pearls

Category: Airway Management

Title: Decompression of Traumatic Tension Pneumothorax

Keywords: trauma, PTX, finger thoracostomy, needle decompression, 2nd intercostal space, 5th intercostal space, pneumothorax (PubMed Search)

Posted: 9/25/2022 by Robert Flint, MD (Updated: 4/22/2024)
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Finger thoracostomy is superior to needle decompression in the fifth mid-axiallary intercostal space which is superior to the traditionally taught needle decompression in the second mid-clavicular intercostal space for traumatic tension pneumothorax/trauamtic arrest.


 SHARON HENRY, MD, FACS ATLS 10th edition offers new insights into managing trauma patients Bulletin of the American College of Surgeons PUBLISHED JUNE 1, 2018 


Scott Weingart, MD FCCM  EMCRIT Podcast 62 – Needle vs. Knife II: Needle Thoracostomy? December 11, 2011 

Hannon, L. et al. .Finger thoracostomy in patients with chest trauma performed by paramedics on a helicopter emergency medical service Emerg Med Australas 2020 Aug;32(4):650-656.doi: 10.1111/1742-6723.13549. Epub 2020 Jun 21

Andy Neil Stop putting IV cannulae in the 2nd ICS for tension PTX Emergency Medicine Ireland Posted on November 15, 2012

Sharrock, k. et al Prehospital paramedic pleural decompression: A systematic review Injury Volume 52, Issue 10, October 2021, Pages 2778-2786