Tension pneumothorax – time to change the old mantra?

 

The universal mantra from medical school of the 2nd ICS mid clavicular line approach is not wrong, it’s just that it might not work in a worst case of up to 50% of trauma patients. We all need to be cognisant that if the patient is obese or has a reasonable pectoral muscle mass, the 5th ICS mid axillary line should be the second port of call, or for some, may even be a more appropriate first line approach.