1. Measure of Chest Wall Thickness in French Soldiers: Which Technique to Use for Needle Decompression of Tension Pneumothorax at the Front?
- Author
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Antoine Lamblin, Pierre-François Wey, Clément Derkenne, Pascal Précloux, Olivier Bylicki, Jean-Yves Martinez, Damien Loheas, and Jean Turc
- Subjects
Adult ,Male ,medicine.medical_specialty ,2nd intercostal space ,Thoracic Injuries ,Body Mass Index ,Standard procedure ,medicine ,Humans ,Thoracic Wall ,Retrospective Studies ,Ultrasonography ,business.industry ,Ultrasound ,Public Health, Environmental and Occupational Health ,Pneumothorax ,Needle decompression ,General Medicine ,Decompression, Surgical ,Tension pneumothorax ,Surgery ,Catheter ,Military Personnel ,medicine.anatomical_structure ,Needles ,Female ,France ,Intercostal space ,Tomography, X-Ray Computed ,business ,Wall thickness ,Nuclear medicine - Abstract
Objectives: Needle decompression of tension pneumothorax in soldiers of the French infantry has a risk for failure when the standard procedure that involves the insertion of a 14-gauge, 5-cm catheter into the 2nd intercostal space (ICS) is used. This study measured the chest wall thickness (CWT) to assess whether this approach is appropriate. Methods: CWT was measured by ultrasound in 122 French soldiers at the 2nd and 4th ICSs on both the right and left sides. Results: CWT was measured at 4.19 cm (±0.96 cm) at the 2nd ICS and 3.00 cm (±0.91 cm) at the 4th ICS (p < 0.001). CWT was greater than 5 cm in 24.2% of cases at the 2nd ICS and 4.9% of cases at the 4th ICS (p < 0.001). Conclusions: This study suggests a high risk of failure when using the technique currently taught in the French army. A lateral approach into the 4th ICS could decrease this risk. The results of this study must be validated in patients presenting tension pneumothorax.
- Published
- 2014
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