So first thing we're going to do is we're going to pop the red top. I'm going to take the needle, withdraw it in my hand so I've got the base of the catheter hub here. I've identified my landmark, and we're going to go to the fifth intercostal space, anterior axillary line. So I find my rib that I'm going to be going down to.

I'm going to place the needle in until I hit rib. I've hit rib here. Now I'm going to back my index finger one, two, three centimeters, and that's going to serve as a stop so I don't over penetrate. And as I insert, I'm going to feel for the pop of the pleural cavity. I'm not going to penetrate any further with the needle.

Now I'm going to take the catheter and I'm going to slide it into the chest cavity while holding the needle still. This will prevent over-penetration of the needle and hitting any vessels. Once I have it hubbed, the catheter, not the needle, I remove the needle, place it in a safe position, and now I should have a good flow of air.

The first thing I'm going to do is reassess my casualty and make sure that we've relieved that tension pneumothorax.