Chest tube

A chest tube or chest drain is a flexible plastic tube that is inserted through the side of the chest into the pleural space. It is used to remove air (pneumothorax) or fluid (pleural effusion) from the space.

The free end of the tube is usually attached to an underwater seal, below the level of the chest. This allows air or fluid to escapre from the pleural space, and prevents it returning back into the chest.

Alternatively, the tube can be attached to a flutter valve. This allows patients with pneumothorax to remain more mobile.

Chest tubes are usually inserted under local anesthesia. The skin over the area of insertion is first cleansed with antiseptic solution before sterile drapes are placed around the area. The local anesthetic is injected into the skin and down to the muscle, and after the area is numb a small incision is made in the skin and a passage made through the skin and muscle into the chest. The tube is placed through this passage. If necessary, patients may be given additional painkillers for the procedure. Once the tube is in place it is stiched to prevent it falling out and a dressing applied to the area. The tube stays in for as long as there is air or fluid to be removed, or risk of air gathering.

Once the drain is in place, an Xray of the chest will be taken to check the position of the drain.