Chest Drain Insertion in Adult Trauma

Authors: Gavin Lloyd / Editor: Steve Fordham / Reviewer: Stewart McMorran, Kathryn Blackmore / Codes: / Published: 03/12/2019

This session provides training in chest drain insertion. It looks at the indications for carrying out this procedure, as well as how to prepare for it, and shows a chest drain being inserted. Post-procedure management and complex cases are also covered.

After completing this session you will be able to:

  • Evaluate the need for a chest drain in injured adults
  • Explain how to safely insert and secure a chest drain
  • Recognise important aspects of chest drain management post-procedure
  • Manage complex cases in which a chest drain may be an integral part

Incorrectly placed chest drains are capable of causing serious injury and death. The recommendations of the NHS National Patient Safety Agency report 2008 [1] are covered by these learning objectives.


  1. National Patient Safety Agency. National Reporting and Learning Service. Chest drains: risks associated with the insertion of chest drains. number 1065, May 2008, NPSA/2008/RRR003.
  2. Is a chest drain necessary in stable patients with traumatic pneumothorax? August 2008, BestBets.
  3. Chest drains in traumatic occult pneumothorax. December 2005, BestBets.
  4. Laws D, Neville E, Duffy J. BTS guidelines for the insertion of a chest drain. Thorax 2003;58(Suppl II):ii53-ii59.
  5. The use of intrapleural anaesthetic to reduce the pain of chest drain insertion. May 2007. BestBets.
  6. Antibiotics in patients with isolated chest trauma requiring chest drains. November 2002. BestBets.
  7. Do patients with a thoracostomy tube placed in the lung fissure need an additional thoracostomy tube placed? August 2008. BestBets.
  8. Advanced Trauma Life Support for Doctors, student course manual 7th edition. 2004. Chicago, Illinois, US
  9. Does it matter whether a chest drain is aimed upwards or downwards for the optimum drainage of fluid or air from the pleural cavity? June 2010. BestBets.

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