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.
