Needle Thoracocentesis
The method of chest drain insertion depends on the circumstances:
The method of chest drain insertion depends on the circumstances:
- Needle thoracocentesis
For emergency relief of tension pneumothorax, a cannula should be inserted vertically into the second intercostal space in the mid-clavicular line, just above the third rib (Fig 1a). The second rib articulates with the sternum at the level of the prominent sternomanubrial joint, also known as the sternal angle. Insertion at this site avoids damage to the subclavian vessels.
The method of chest drain insertion depends on the circumstances:
- Needle thoracocentesis
- Formal chest drain
This longer-term drain is inserted into the fifth intercostal space in the mid-axillary line (Fig 1b). Count down from the second rib to the fifth intercostal space below the fifth rib. The neurovascular bundle lies in a groove under the rib. Make the incision just above the lower rib. Insertion here avoids the risk of damage to internal organs such as the liver, spleen or heart.
