Pleural Interventions - Chest Drain Insertion

Historically, chest drain insertion has been one of the most common procedures for respiratory doctors and the skill is also practiced by many other specialities throughout the hospital. In recent years, management of pleural disease has moved toward the outpatient setting which has reduced the number of chest drains inserted, but there are still many cases where intercostal drain insertion is still vital. This article reviews the indications for chest drain insertion and highlights when this would be recommended instead of alterative outpatient management. The debate regarding drain size will be reviewed along with the options for different methods of insertion. A detailed description of the techniques will be documented along with possible complications. Lastly, drain management including Heimlich valves and timing for removal will be discussed. This article aims to cover all aspects of chest drain insertion, to allow for confident decision making from start to finish.