Chest drain insertion

• The bigger the better in trauma (32-36Fr)

• Procedure

  • LA to skin, periosteum, intercostal space
  • 2-3 cm incision along line of rib
  • single oblique tunnel into pleural cavity
  • finger dissect pleura
  • listen for the hiss as you open the chest
  • place drain and suture it

• CXR for drain placement

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