Measure of Chest Wall Thickness in French Soldiers: Which Technique to Use for Needle Decompression of Tension Pneumothorax at the Front?. Issue 7 (1st July 2014)

• Record Type: Journal Article
• Authors: Lamblin, Antoine; Turc, Jean; Bylicki, Olivier; Lohéas, Damien; Martinez, Jean-Yves; Derkenne, Clément; Wey, Pierre-François; Précloux, Pascal
• Is Part Of: Military medicine. Volume 179:Issue 7(2014)
• Page Start: 783
• Page End: 786
• Publication Date: 2014-07-01
• Subjects: Surgery, Military -- Societies, etc; Medicine, Military -- Societies, etc; Medicine, Military -- Periodicals; Surgery, Military -- Periodicals; Medicine, Military; Surgery, Military; Military Medicine -- Periodicals; Periodicals; Electronic journals; 616.98023
• DOI: 10.7205/MILMED-D-13-00512
• Languages: English
• ISSNs: 0026-4075

Abstract

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.