Transcript Chest Drain - fundamentals

Chest Drain - fundamentals
Pleural Aspiration –Tension Pneumothorax
• 2nd intercostal space midclavicular line
• Use venflon or central line catheter (avoid
sharp needle’s)
• O2
• Then arrange for chest drain
“There is no organ in the thoracic or
abdominal cavity that has not been
pierced by a chest drain.”
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
Position-for Pleural aspiration/
Thoracocentesis ONLY
Position - Triangle of safety
Chest Drain Insertion Steps
Chest Drain Insertion Steps…
Underwater Seal Options
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)
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