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 2: The Use of Flutter valves

In some specialised respiratory environments a flutter valve can be inserted onto the drain rather than the traditional underwater seal drainage system. This one-way valve allows air to leave the pleural space but not re-enter. This system has some advantages in the on-going management of conditions such as a complicated pneumothorax, as it allows the patient to be more mobile and potentially be able to be discharged home with a drain in place. These valves should only be used in specialised clinical settings and have no role in the initial generic management of a patient who needs a chest drain. Note: there are case reports of patients accidentally reversing their own Heimlich valves leading to Tension Pneumothorax.

Figure 17. Heimlich Flutter Valve