Sonographic evaluation of chest wall thickness in Chinese adults in Hong Kong: Should the updated (10th edition) Advance Trauma Life Support guidelines on preferred site of needle thoracocentesis in tension pneumothorax be adopted in the Asian population?

• Published in: Trauma (London, England) England), 2021-04, Vol.23 (2), p.120-126
• Main Authors: Dorothy Pui-Ming Yu, Stephanie, Siu Ki Lau, James, Leung Mok, Ka, Gay Kan, Pui
• Format: Article
• Language: English
• Subjects: Adults; Chest; Confidence intervals; Decompression; Guidelines; Patients; Pneumothorax; Population studies; Tension; Thickness measurement; Trauma; Ultrasonic imaging; Ultrasound
• ISSN: 1460-4086; 1477-0350
• DOI: 10.1177/1460408620934361

Objective To compare the anterior with lateral mean chest wall thickness measured by bedside ultrasound in Chinese adults in order to suggest a preferred site for needle decompression in tension pneumothorax. Study design This was an observational cross-sectional study conducted in a regional hospital over three months. Subjects were recruited by convenience sampling. Chest wall thickness at the second intercostal space, mid clavicular line, fifth intercostal space, anterior axillary line and fifth intercostal space and mid axillary line was measured using ultrasound on both sides. Range, mean values and confidence intervals were calculated. Results One-hundred and fourteen subjects were recruited. The mean anterior chest wall thickness was 2.62 cm (at second intercostal space, mid-clavicular line) and mean lateral chest wall was 2.68 cm (at fifth intercostal space, anterior axillary line) and 2.87 cm (at fifth intercostal space and mid-axillary line) respectively. Chest wall thickness at fifth intercostal space and mid-axillary line was significantly greater than second intercostal space, mid-clavicular line (p