RT Journal
A1 Schreiber MA
T1 The death of another sacred cow: Comment on “radiologic evaluation of alternative sites for needle decompression of tension pneumothorax”
JF Archives of Surgery
JO Archives of Surgery
YR 2012
FD September 1
VO 147
IS 9
SP 818
OP 819
DO 10.1001/archsurg.2012.759
UL http://dx.doi.org/10.1001/archsurg.2012.759
AB 
Generations of advanced trauma life support students have been taught that placing a 5-cm needle in the fifth ICS at the MCL is one of the fastest and easiest ways to save the life of a patient with a tension pneumothorax. This article1 is another in a series of assaults by Dr Inaba and his colleagues on this very basic concept. In their previous work,2 Dr Inaba placed 5-cm needles in cadavers and then performed thoracotomies to see whether the needles entered the chest. They found that 100% of needles placed in the fifth ICS at the AAL entered the chest, while only 58% of needles placed in the second ICS at the MCL did so.