title: Chest wall thickness may limit adequate drainage of tension pneumothorax by needle thoracocentesis.
abstract: Tension pneumothorax in a large man was inadequately drained by needle thoracocentesis with a 4.5 cm cannula. Unsuccessful needle thoracocentesis of a clinical tension pneumothorax in a large patient should be followed immediately by chest drain insertion, without local anaesthetic, as dictated by clinical urgency. If the clinical situation is still not improved other diagnoses should be considered.
authors.affiliation: Royal United Hospital, Bath, United Kingdom.
authors.forename: S
authors.initials: S
authors.lastname: Britten
authors.forename: S H
authors.initials: SH
authors.lastname: Palmer
mesh_terms: D000062:Accidents, Occupational; D015505:Chest Tubes; D006801:Humans; D008297:Male; D008875:Middle Aged; D011030:Pneumothorax / Q000601:surgery*; D011677:Punctures / Q000379:methods; D013898:Thoracic Injuries / Q000601:surgery; D013907:Thoracostomy / Q000295:instrumentation* / Q000379:methods; D017211:Treatment Failure