Changing Trends in the Decompression of Tension Pneumothorax

Author(s): Sherreen Yehia Elhariri, Hassan Mohamed, Ismail AS Burud, Ahmed Elhariri

Tension Pneumothorax (TP) is one of the commonest complication of chest trauma. For many years the management for tension pneumothorax decompression was the immediate insertion of a wide bore Cather (14-16 gauge) into the 2nd intercostal space (ICS) in mid-clavicular line (MCL) followed by the insertion of a chest tube in the 5th ICS anterior to the mid-axillary line (MAL). In 2018 the Advanced Trauma life support (ATLS) guidelines has changed and the ideal place for tension pneumothorax decompression is at the 5th intercostal space anterior to the MAL. The thickness of the chest wall is significantly less at the 5th intercostal space MAL when compared to 2nd ICS in MCL, and that an 8 cm length Cather has a better efficacy in comparison to 5 cm catheter, as proved by radiographic
measurements. In our article we reviewed the literature in response to the new policy in different countries.