We're placing a needle decompression on the right anterior chest, second intercostal space. One way to hold it is with the hub seated in your palm, and then your finger. What mark are you going to put that on, Jen?

Well, once I identify how deep my patient's going to be, I'm tapping on the rib, then I can get my three centimeters back.

So we're going to make sure we're penetrating how far beyond the rib?

Just three centimeters.

Three centimeters beyond the rib, and that's what those marks will help you to do. Holding it in the palm of your hand will help it from separating. She's keeping the hub and the needle, so the needle and the catheter from separating, and then she's also ready to place those marks.

One of the big things you have to see is noticing the angle that I'm approaching this chest. I'm getting perpendicular to the actual rib cage here. So now you can see I'm bouncing on that rib. So now I can go ahead and get my three-centimeter marking. I'm going to avoid the neurovascular bundle below the rib, so I'm going up and over the rib towards the head. I either feel it pop, or I go towards the centimeter marking that I marked. Now I'm going to change my angle, stabilize the needle, and thread the catheter into the chest.