TY - JOUR T1 - Chest wall thickness may limit adequate drainage of tension pneumothorax by needle thoracocentesis. JF - Journal of Accident & Emergency Medicine JO - Arch Emerg Med SP - 426 LP - 427 DO - 10.1136/emj.13.6.426 VL - 13 IS - 6 AU - S Britten AU - S H Palmer Y1 - 1996/11/01 UR - http://emj.bmj.com/content/13/6/426.abstract N2 - 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. ER -