Chest Drain - fundamentals

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Chest Drain - fundamentals
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Pleural Aspiration Tension Pneumothorax

• 2nd intercostal space midclavicular line
• Use venflon or central line catheter (avoid sharp
  needles)
• O2
• Then arrange for chest drain

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There is no organ in the thoracic or abdominal
cavity that has not been pierced by a chest
drain.
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Safety Precautions

• Consent Written informed
• Lignocaine test dose
• Check Ensure the side (right or left) of ICD
• Clinical Examination
• CXR
• O2 must be connected
• SpO2 Monitor

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Position-for Pleural aspiration/ Thoracocentesis
ONLY
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Position - Triangle of safety
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Chest Drain Insertion Steps
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Chest Drain Insertion Steps
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Underwater Seal Options
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Post ICD Care

• Adequate pain control
• Ambulate Chest physiotherapy, O2,
  Nebulisation
• NEVER Clamp the chest drain if BPF is
  persistent ICD clamping may create tension
  pneumothorax
• Assess for air leak on asking to take deep breath
  or on coughing confirm NO air leak
• Chest x-ray
• ICD column not moving ?
• Lung is fully expanded
• Blocked (less likely in 28/32 drain)

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When to Remove ICD

• NO Air leak (BPF has closed)
• Assess for air leak on asking to take deep breath
  or on coughing confirm NO air leak
• Lung Fully Expanded
• Clinically
• Chest x-ray
• Drainage is less than 100ml/24hrs