{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T09:04:05Z","timestamp":1782983045612,"version":"3.54.5"},"reference-count":9,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2011,9,26]],"date-time":"2011-09-26T00:00:00Z","timestamp":1316995200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Academic Emergency Medicine"],"published-print":{"date-parts":[[2011,10]]},"abstract":"<jats:sec><jats:label\/><jats:p>ACADEMIC EMERGENCY MEDICINE 2011; 18:1022\u20131026 \u00a9 2011 by the Society for Academic Emergency Medicine<\/jats:p><\/jats:sec><jats:sec><jats:title>Abstract<\/jats:title><jats:p><jats:bold>Objectives:\u2002<\/jats:bold> Recent research describes failed needle decompression in the anterior position. It has been hypothesized that a lateral approach may be more successful. The aim of this study was to identify the optimal site for needle decompression.<\/jats:p><jats:p><jats:bold>Methods:\u2002<\/jats:bold> A retrospective study was conducted of emergency department (ED) patients who underwent computed tomography (CT) of the chest as part of their evaluation for blunt trauma. A convenience sample of 159 patients was formed by reviewing consecutive scans of eligible patients. Six measurements from the skin surface to the pleural surface were made for each patient: anterior second intercostal space, lateral fourth intercostal space, and lateral fifth intercostal space on the left and right sides.<\/jats:p><jats:p><jats:bold>Results:\u2002<\/jats:bold> The distance from skin to pleura at the anterior second intercostal space averaged 46.3\u2003mm on the right and 45.2\u2003mm on the left. The distance at the midaxillary line in the fourth intercostal space was 63.7\u2003mm on the right and 62.1\u2003mm on the left. In the fifth intercostal space the distance was 53.8\u2003mm on the right and 52.9\u2003mm on the left. The distance of the anterior approach was statistically less when compared to both intercostal spaces (p\u2003&lt;\u20030.01).<\/jats:p><jats:p><jats:bold>Conclusions:\u2002<\/jats:bold> With commonly available angiocatheters, the lateral approach is less likely to be successful than the anterior approach. The anterior approach may fail in many patients as well. Longer angiocatheters may increase the chances of decompression, but would also carry a higher risk of damage to surrounding vital structures.<\/jats:p><\/jats:sec>","DOI":"10.1111\/j.1553-2712.2011.01159.x","type":"journal-article","created":{"date-parts":[[2011,9,28]],"date-time":"2011-09-28T01:26:26Z","timestamp":1317173186000},"page":"1022-1026","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":38,"title":["Anterior Versus Lateral Needle Decompression of Tension Pneumothorax: Comparison by Computed Tomography Chest Wall Measurement"],"prefix":"10.1111","volume":"18","author":[{"given":"Leon D.","family":"Sanchez","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shannon","family":"Straszewski","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amina","family":"Saghir","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atif","family":"Khan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erin","family":"Horn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Fischer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Faisal","family":"Khosa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc A.","family":"Camacho","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2011,9,26]]},"reference":[{"key":"e_1_2_7_2_2","volume-title":"Student Course Manual. 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