Title: Needle Decompression for Tension Pneumothorax
题目：张力性气胸的穿刺减压（的新位置）
Author作者: Michael Winters

Needle Decompression - Are we Teaching the Right Location?
穿刺减压－我们教的位置正确吗？
• Tension pneumothorax frequently results in circulatory collapse and may lead to cardiopulmonary arrest.
• 张力性气胸会常导致循环衰竭和心肺骤停。
•
• In the event that tube thoracostomy cannot be immediately performed, traditional teaching is to perform needle decompression in the second intercostal space, mid-clavicular line using a 5-cm angiocath needle.
• 在不能立即放置胸导管的情况下，传统的穿插减压教学是在第二个肋间隙和锁骨中线交叉点插入一个5厘米的套管针。
•
• Recent literature, however, has challenged the traditional location for needle decompression. In fact, researchers found:
• 但是，近期文献对穿刺减压的传统位置提出了疑问。实际上，科研人员发现：
◦ Needles placed in the second intercostal space often failed to enter the chest cavity and relieve tension physiology.
◦ 在第二肋间隙放置穿刺针，经常不能进入胸腔，解除高张的生理作用。
◦ Needles placed in the fifth intercostal space in the anterior axillary line were more likely to enter the chest cavity with a lower failure rate.
◦ 在第五肋间隙和腋前线交叉点进针，更容易进入胸腔，失败率低。
◦
• Take Home Point: It may be time to reconsider the optimal position for needle decompression of tension pneumothorax.
• 要点：可能是时候考虑张力性气胸穿刺减压的最佳位置了。
•
References参考文献
Inaba K, et al. Optimal positioning for emergent needle thoracostomy: A cadaver-based study. J Trauma 2011; 71:1099-1103.
Inaba K, et al. Radiologic evaluation of alternative sites for needle decompression of tension pneumothorax. Arch Surg 2012; 147:813-818.
Martin M, et al. Does needle decompression provide adequate and effective decompression of tension pneumothorax? J Trauma 2012; 73:1412-1417.