Complications of Needle Thoracostomy Pulmonary or diaphragmatic laceration Intercostal neuralgia due to injury of the neurovascular bundle below a rib Bleeding Infection Pneumothorax (if the procedure was done because of falsely suspected pneumothorax) Rarely, perforation of other structures in the chest or abdomen Equipment for Needle Thoracostomy A 14 - or 16-gauge needle (an over-the-needle catheter is best); 8-cm needles are more successful than 5-cm needles but increase the risk of injury to underlying structures Sterile gown, mask, gloves Cleansing solution such as 2% chlorhexidine solution Additional Considerations for Needle Thoracostomy The urgency of the procedure is determined by the patient's condition.