You'd better be carrying a longer catheter....
Quote:
Mil Med. 2007 Dec;172(12):1260-3.
Chest wall thickness in military personnel: implications for needle thoracentesis in tension pneumothorax.
Harcke HT1, Pearse LA, Levy AD, Getz JM, Robinson SR.
Author information
Abstract
Needle thoracentesis is an emergency procedure to relieve tension pneumothorax. Published recommendations suggest use of angiocatheters or needles in the 5-cm range for emergency treatment. Multidetector computed tomography scans from 100 virtual autopsy cases were used to determine chest wall thickness in deployed male military personnel. Measurement was made in the second right intercostal space at the midclavicular line. The mean horizontal thickness was 5.36 cm (SD = 1.19 cm) with angled (perpendicular) thickness slightly less with a mean of 4.86 cm (SD 1.10 cm). Thickness was generally greater than previously reported. An 8-cm angiocatheter would have reached the pleural space in 99% of subjects in this series. Recommended procedures for needle thoracentesis to relieve tension pneumothorax should be adapted to reflect use of an angiocatheter or needle of sufficient length.
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EDIT: If you really need to needle decompress someone, place the needle in the 5th ICS MAL, NOT where you were taught at the 2nd ICS MCL.....