Azizi N, ter Avest E, Hoek AE, et al. - Given the proposal of both the 2nd intercostal space in the midclavicular line (ICS2-MCL) and the 4th/5th intercostal space in the anterior axillary line (ICS 4/5-AAL) as preferred locations for needle decompression (ND) of a tension pneumothorax (TP), researchers sought to determine chest wall thickness (CWT) at ICS2-MCL and ICS4/5-AAL in normal weight-, overweight- and obese patients, and estimated theoretical success rates of ND for these locations based on standard catheter length. In this prospective multicenter study, they included a total of 392 patients [Mean age: 51 years (range 18-89)] who presented in Emergency Departments (ED) of 2 university hospitals and 6 teaching hospitals participating in the XXX consortium. Of these patients, 52% was male; their mean BMI was 25.5. Observations suggest correlation of chest wall thickness (CWT) with BMI. Overweight- and obese individuals have thinner mean CWT in the 2nd intercostal space in the midclavicular line (ICS2-MCL) compared with the 4th/5th ICS in the anterior axillary line (ICS 4/5-AAL). ICS2-MCL vs ICS 4/5-AAL is correlated with significantly higher theoretical changes of successful needle decompression of a tension pneumothorax using standard equipment.