A doctor inserts a chest tube, a thin plastic tube, into the pleural space. This is the space between the chest wall (and the lungs).
A surgical chest tube drainage system may be used by doctors for many reasons, including to inflate a collapsed lung or drain fluid or blood or deliver medications. This article will explain how chest tubes work and what to expect during the procedure.
A doctor might put someone under general anesthesia to allow for the insertion of a chest tube. They may also use local anesthesia to numb the area prior to inserting the tube.
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Although there are many options for incisions to insert the chest tube, the process will be the same.
- Lifting the head of someone's bed by between 30-60 degrees. Usually, someone will raise the arm on their affected side above their head.
- Locating the tube insertion site. It will be located between the fourth and sixth ribs or between the fifth and sixth, just below the pectoralis (chest).
- Cleanse the skin using a solution such as chlorhexidine or povidone-iodine. The doctor will let the skin dry completely before covering the patient with a sterile wrap.
- Use local anesthetic to numb. A doctor might insert a deeper needle to check if fluid or air can be pulled back from the area. This will confirm they are in the correct area.
- Make an incision through the skin of approximately 2-3 cm. The Kelly clamp is a surgical instrument that allows the doctor to expand the incision and access the pleural space. To avoid puncturing the lungs, it is important to slow down when inserting the clamp.
- Inserting a gloved hand into the incision site. This is done to verify that the incision site is the pleural area. Unexpected findings such as scar tissue or a mass will be checked by the doctor.
- Inserting a chest tube through the incision site. If fluid drains through the tube, it's in the right spot. You can attach the tube to a container that contains water. This water will move when the person breathes. The tube might need to be repositioned if this happens.