The preferred insertion site is the 2nd intercostal space in the mid-clavicular line in the affected hemithorax. However, insertion of the needle virtually anywhere in the correct hemothorax will decompress a tension pneumothorax.

Where should needle decompression be placed?

The most recent Advanced Trauma Life Support manual recommends “inserting a large-caliber needle into the second intercostal space in the midclavicular line of the affected hemithorax,” but also notes that chest wall thickness can affect the chances of successful needle decompression.

Where do you put the needle for pneumothorax?

Needle thoracocentesis is a life saving procedure, which involves placing a wide-bore cannula into the second intercostal space midclavicular line (2ICS MCL), just above the third rib, in order to decompress a tension pneumothorax, as per Advanced Trauma Life Support (ATLS) guidelines.