Triangle of safety

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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 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 .

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.