Modifications 1: The use of USS in chest drain insertion
Ultrasound (USS) is used to localise fluid to guide the insertion of a chest drain, which is particularly useful if fluid is locualted. Bedside USS such as the FAST scans used in initial trauma care can also localise a haemothorax. USS localisation and marking of insertion site by Radiologists does not obviate the risks of misplacement and the safest practice is to insert the drain while USS guidance is present rather than at a later stage. USS is recommended if blind aspiration of an effusion fails on the first attempt.
As the use of bedside USS grows rapidly within specialities such as Emergency Medicine and Surgery, it may become standard practice that all chest drains are inserted under USS guidance.
Best Practice Statement
Ultrasound guidance is strongly recommended when inserting a drain for fluid
Rationale: Minimise risk of damage to underlying structures
Source of Evidence: NPSA