Critical Care Medicine-Pulmonary Disorders>>>>>Pleural Disorders
Question 4#

The proper position for chest tube placement in a patient with a pneumothorax is:

A. Second intercostal space mid-axillary line
B. Fifth intercostal space posterior axillary line
C. Third intercostal space mid-clavicular line
D. Fourth intercostal space anterior axillary line

Correct Answer is D

Comment:

Correct Answer: D

Chest tube insertion for evacuation of air is most appropriately placed in the fourth or fifth intercostal space at the mid to anterior axillary line. Placement more posterior runs the risk of liver or spleen injury depending on side. Placement more superiorly into the axilla runs the risk of nerve or vascular damage.

Reference:

1. Dalbec DL, Krome RL. Thoracostomy. Emerg Med Clin North Am. 1986;4(3):441.