Standard Length Angiocatheter Sufficient for Pediatric Needle Thoracostomy

Longer angiocatheter lengths suggested by Advanced Trauma Life Support guidelines for adults are not needed in children and might cause harm.

Needle thoracostomy is a critical lifesaving procedure for patients with tension pneumothorax. Several studies suggest that the standard angiocatheter length (3.8 cm) is insufficient to reach the pleural space in adults. Advanced Trauma Life Support guidelines suggest using a longer, 5 cm angiocatheter and consideration of 8 cm in select patients. Evidence for the appropriate catheter length to use in children is sparse, and length-based decision aids (e.g., the Broselow tape) do not address needle thoracostomy.

Researchers measured chest wall thickness at the second intercostal midclavicular and fourth intercostal anterior axillary spaces on clinical computed tomography scans from 250 children younger than 13 years who were stratified into …

Reviewing Author

Jason T. McMullan, MD, MS, FAEMS

Disclosures

Consultant/Advisory BoardEMCREG International

Grant/Research SupportNIH; Department of Defense

Editorial BoardsJournal of Emergency Medical Services

Leadership Positions in Professional SocietiesNational Association of EMS Physicians (Chair, Research Committee)