chest drains 3

Question 1

l, chest drains may be removed

once they are

Answer 1

no longer draining any fluid and any

air leak has resolved.

Question 2

With a pneumothorax, drains
should not be removed until the operator is satisfied
that there is

Answer 2

no longer any ‘bubbling’ or an air leak
and the pneumothorax has resolved, confirmed by
chest radiograph

Question 3

With a haemothorax or pleural effusions, drains should not be removed if there is evidence
of

Answer 3

continued drainage or evidence of residual blood or

effusion on chest radiograp

Question 4

The tube should be removed with two

people present

Answer 4

The tube should be removed with two
people present. One person should remove the tube in a
brisk and firm movement, whilst the other ties down the
previously placed closure suture to prevent air being
sucked in.12,14

Question 5

Complication early chest drain

Answer 5

Haemothorax due to laceration of intercostal
vessels;
. Lung laceration due to inadequate clearance of
pleural adhesions;
The drain placed too far into the thoracic cavity
causing pain; and
. The chest drain falling out due to it not being
secured effectively.

Question 6

Complication late chest drain

Answer 6

. Chest drain blockage;
. Failure of drainage of pleural effusion or haemothorax due to sub-optimal drain placement or
change in drain position;
. Wound infection;
. Empyema; and
. Post-removal pneumothorax due to removing the
drain too early, poor technique or ongoing air leak.

Question 7

Chest drains are to be inserted by staff

Answer 7

with relevant
competencies and adequate supervision
A lead for training of all staff involved in chest drain
insertion must be identified;

Question 8

Written evidence of consent

Answer 8

must be obtained from

the patient before the procedure wherever possible

Question 9

Ultrasound guidance is strongly advised

Answer 9

when inserting a chest drain for fluid