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Needle decompression of a tension pneumothorax can be lifesaving but is not always successful, particularly if the needle is not long enough to reach the pleural space. In a retrospective study, researchers used chest computed tomography images to measure chest wall thickness in 110 patients (82 men; average age, 43.5) at a single level I trauma center during a 3-month period. Bilateral chest wall thickness was measured at the second intercostal space, midclavicular line.
Average chest wall thickness was 4.5 cm on the right side and 4.1 cm on the left side. The average of both sides was 5.1 cm in women and 4.0 cm in men. Half the patients had at least one side with a chest wall thickness greater than 4.4 cm (the length of the standard angioc…