Stop doing needle decompression @ 2nd ICS MCL -Critical structures in region: aortic arch, L atrium, great vessels -Poor location based on data(PMID: 16244336 + 26724173) Go 4th/5th ICS anterior axillary line. Even better, ditch needle + do a finger thoracostomy youtube.com/shorts/4MK6t...

2 comments — live from bluesky

Steven Ilko 🏥 🚁💨 · 4 · 2d ago
Especially with American habitus.... I often like to show my residents with ultrasound or cross sectional imaging how far away the target ends up being and what is the neighborhood.
Anand Swaminathan · 1 · 2d ago
Great way to hammer this home. Agreed and I’ve ditched the needle completely. All you need is a scalpel and a finger
savagebastard.bsky.social · 1 · 2d ago
We actually just talked about this recently and get a lot of errant placed field needles at the anterior axillary. The biggest problem with 2nd ICS was plafmeents too medial or not deep enough, generally fixed with longer needles. Finger is great for those of us who can do them.