Chest Drains Online Skills Pack

Table of Contents

1. Chest Drain Programme
2. Essential Pre-requisite Knowledge
3. Large bore chest drain insertion
4. Small-bore chest drain insertion
   1. Technique 2 - Small-bore Seldinger chest drain insertion
   2. Modifications 1: The use of USS in chest drain insertion
   3. Modifications 2: The Use of Flutter valves
5. Pre-hospital chest drain insertion
6. Chest drain management
7. Chest drain Removal
8. Risk Factors of Chest Drain Management
9. Theoretical Assessment - Chest Drains
10. Housekeeping
11. Appendices

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 loculated. 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.