Insertion site = mid- to ant axillary line at 4th/5th intercostal space
~Nipple line in men, inframammary crease in women
Place 1-3 intercostal spaces higher in pregnant patients (esp those in 3rd trimester) due to elevated diaphragm.
~Nipple line in men, inframammary crease in women
Place 1-3 intercostal spaces higher in pregnant patients (esp those in 3rd trimester) due to elevated diaphragm.
Must anesthetize skin, soft tissue, muscle, periosteum, and pleural space
Ensure that inner tract/incision can fit your finger and<unk> 
It helps to have your finger in the tract and pass the<unk>  along your finger, particularly in obese patients
Aim superoanterior for pneumothorax; aim posteriorly for hemothorax
Controversial as to whether this is important
Controversial as to whether this is important
Reduces likelihood of<unk>  kinking
If<unk>  rotates easily, can help indicate correct location inside pleural cavity
Most spontaneous pneumothorax (primary and secondary)
Most iatrogenic pneumothorax
Alveolar-pleural fistulae (small air leak)
Iatrogenic air
Traumatic pneumothorax
Traumatic hemothorax ("any acute hemothorax visible on<unk>  radiograph")
Pneumothorax on mechanical ventilation
Non-traumatic tension pneumothorax
Malignant effusion
Trauma/bleeding (hemothorax/hemopneumothorax)
Bronchial-pleural fistulae (large air leak)
Malignant fluid
Empyema
Thick pus
Spontaneous pneumothorax
The least amount of suction (including none) needed to maintain full expansion of the lung is appropriate
Starting with Heimlich valve (no suction) or -10 cm of water and increasing only as needed
Fluid drainage
-20 cm of water
Increased as indicated with the goal of achieving full lung expansion
For thoracic trauma, few data are available
Start -20 cm of water
The least amount of suction (including none) needed to maintain full expansion of the lung is appropriate
Starting with Heimlich valve (no suction) or -10 cm of water and increasing only as needed
-20 cm of water
Increased as indicated with the goal of achieving full lung expansion
Start -20 cm of water
Chest tube
Thoracotomy 
Thoracotomy
Arterial line
Needle thoracostomy
Finger thoracostomy
Thoracic lavage
Pulmonary artery catheter