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