Triangle of safety

Last revised by Craig Hacking on 5 Apr 2018

Citation, DOI, disclosures and article data

Citation:

Hacking C, Qureshi P, Kang O, Triangle of safety. Reference article, Radiopaedia.org (Accessed on 16 Apr 2024) https://doi.org/10.53347/rID-45249

DOI:

https://doi.org/10.53347/rID-45249

Permalink:

https://radiopaedia.org/articles/45249

rID:

45249

Article created:

19 May 2016, Craig Hacking ◉ ◈

Disclosures:

At the time the article was created Craig Hacking had no recorded disclosures.

View Craig Hacking's current disclosures

Last revised:

5 Apr 2018, Craig Hacking ◉ ◈

Disclosures:

At the time the article was last revised Craig Hacking had no recorded disclosures.

View Craig Hacking's current disclosures

Revisions:

4 times, by 3 contributors - see full revision history and disclosures

Systems:

Chest

Sections:

Anatomy, Approach

Synonyms:

Safe triangle
Safety triangle for ICC
Safe triangle for ICC

The triangle of safety is an anatomical region in the axilla that forms a guide as to the safe position for intercostal catheter (ICC) placement. With the arm abducted, the apex is the axilla, and the triangle is formed by the:

lateral border of the pectoralis major anteriorly
lateral border of the latissimus dorsi posteriorly
inferiorly, by a horizontal line from the nipple (commonly the 5^th intercostal space)

There have been cases reported of complications from ICC placement even when using these landmarks, with authors advising the supplementary use of ultrasound visualization ¹.

As with all intercostal approaches, placing the catheter closer to the superior border of the rib below in the intercostal space should avoid injury to the intercostal neurovascular bundle under the costal groove of the rib above.