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Author: Jake Toy, MSIII
Western University of Health Sciences
Needle thoracostomy (NT) is a lifesaving procedure often utilized in pre-hospital settings and emergency departments (ED), and is indicated in cases of tension pneumothorax. Placement of a needle catheter into the pleural space allows for emergent decompression, resulting in restored and/or increased venous return to the right atrium. Placement of a chest tube is the definitive management of a tension pneumothorax following both a successful or failed needle placement. Advance Trauma Life Support (ALTS) guidelines recommend the use of a 14-gauge 5 cm (approx. 2 in) angiocatheter placed in the 2nd intercostal space, midclavicular line (ICS-MCL), inserted at a perpendicular angle to the skin.