Procedural Checklists - Removal of Chest Drain

Task N/A
Introduce yourself to the patient. Ensure that you have the correct patient by checking name, date of birth and CHI against arm band and notes
Explain the procedure to the patient and obtain informed consent
Get patient to practise Valsalva
Gather equipment
Ensure patient is lying comfortably with the arm on the side of the drain behind the head
Administration of oral or intravenous analgesia
Wash hands and put on sterile gloves and apron
Remove dressing and identify 'stay' and 'close' sutures
Isolate 'close' suture to tie once drain removed
Clean wound with antiseptic skin preparation such as chlorhexidine
Cut the stay suture
Ask the patient to perform Valsalva, firmly pull chest drain out and get assistant to apply pressure to wound
Clean wound with antiseptic skin preparation such as chlorhexidine
Tie other suture to close wound, not too tightly, apply a few steristrips if necessary
Apply occlusive dressing
Perform repeat chest x-ray to make sure that original pathology has not recurred
Record procedure, including any complications in the patient's notes
Regularly check patient's observations and drain site in the hours after removal


Adapted from L. Malek - SCOTS Project, Procedural Checklists

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