Chest Tube Insertion

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Chest tube is a flexible plastic tube that is inserted through the chest wall and into the pleural Space or mediastinum.
Indication of chest tube insertion:

•  trauma in the chest such as RTA.
• pneumothorax OR hemothorax.
•  pleural effusion due to bleeding into the chest, buildup of fatty fluid, abscess or pus buildup in the lung or the chest, or heart failure
• Flail chest 

Contraindications of chest tube insertion:

1.                  Infection over insertion site

2.                  Uncontrolled bleeding diathesis

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Materials

1.                  Chest tube with or without trocar; OR Fuhrman catheter

2.                  Chest tube suction unit , tubing, wall suction hookup

3.                  Chest tube tray to include scalpel blade and handle, large Kelly clamps, needle driver, scissors

4.                  Packet of 0 or 1.0 silk suture on a curved needle

5.                  Tape, gauze.

6.                  2% lidocaine with epinephrine injection, 20 cc syringe, 23-gauge needle for infiltration

7.                  Sterile prep solution; mask, gown and gloves.

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 Location (Safety triangle):
1) lateral border of the pectoralis major muscle
2) anterior border of the latissimus dorsi
3) Imaginary horizontal level of the nipple
Area of insertion 4th to 6th intercostal space anterior to Mid-axillary line

Posted in: Emergency,Surgery