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There is no difference in rate or type of complications between axillary and chest wall port location. Subcutaneous ports can safely be placed in the mid axillary line. Axillary ports spare the patient the negative cosmetic outcomes of chest wall ports.

A 67-year-old woman was backing out of her driveway into a major road when her car was struck on the left side by a speeding vehicle. On presentation in the trauma room she was without vital signs and had rare wide qrs complexes. Minimal evidence of head trauma existed. A lateral x-ray was taken ( Fig. 1) revealing craniocervical dissociation. She was pronounced dead at that time.A 73-year-old woman was hit on the driver door by a rapidly moving truck as she was attempting to pass through an intersection. In the trauma room she was without vital signs and had severe bleeding from her ears and multiple large scalp lacerations. A lateral x-ray of the head (Fig. 2) revealed very significant frontal pneumocephalus. She was pronounced dead.Commonly, we encounter death in the trauma room and wonder what the fatal injury was. We are hampered too often in this quest by a system that discourages autopsy when "the patient obviously died from injuries sustained in a motor vehicle collision." We recommend the liberal use of anteroposterior and lateral head and neck films and an anteroposterior film of the chest in the trauma room of appropriate patients to answer some questions for the health care provider. They are sometimes educational and are maybe even somewhat therapeutic for the caregivers.

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