Abstract

Chest tube placement into the pleural cavity is performed to drain abnormal collections of air or fluid, or as a means to instil medications to perform pleurodesis. The choice of chest tube and insertion site depends on the indication for placement and the nature of the fluid/air to be drained. Small drains should be used for pneumothorax, free-?owing pleural effusions and pleural infection, and analgesia should be considered as a pre-medication. It is strongly recommended that all chest tubes for ?uid should be inserted under image guidance. The tube should be inserted using full aseptic technique, and substantial force should never be used. Blunt dissection should be employed in cases of trauma or insertion of large-bore drains. Chest tubes should be managed on wards familiar with their management, and checked daily for ?uid drainage volumes and any signs of wound infection, and documented for swinging and/or bubbling. The chest tube should be removed once pneumothorax has resolved and ?uid drainage has decreased to <200 mL per day.