Appropriate Needle Length for Emergent Pediatric Needle Thoracostomy Utilizing Computed Tomography

摘要

Objective: Needle thoracostomy is a life-saving procedure. Advanced Trauma Life Support guidelines recommend insertion of a 5?cm, 14-gauge needle for pneumothorax decompression. High-risk complications can arise if utilizing an inappropriate needle size. No study exist evaluating appropriate needle length in pediatric patients. Utilizing computed tomography (CT), we determined the needle length required to access the pleural cavity in children matched to Broselow? Pediatric Emergency Tape color. Methods: Three investigators reviewed chest CTs of children 115.1?cm): 2nd ICS-MCL of 2.45?cm (95% CI 2.3?cm, 2.6?cm), 4th ICS-AAL 2.19cm (95% CI 2.02?cm, 2.36?cm). Conclusion: Median chest wall thickness varies little by height or location in children <13 years of age. The standard 5-cm needle is twice the chest wall thickness of most children. Commercially available 14?g or 16?g standard-length 3.8?cm (1? inch) needles are of adequate length to access the pleural cavity, regardless of height as measured by Broselow LBT.