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Chapter 3 - Thoracostomy Tube Insertion

from Section 2 - Resuscitative Procedures in the Emergency Room

Published online by Cambridge University Press:  21 October 2019

By
Demetrios Demetriades  and
Caroline Park
Edited by
Demetrios Demetriades ,
Kenji Inaba  and
George Velmahos
Demetrios Demetriades
Affiliation:
University of Southern California
Kenji Inaba
Affiliation:
University of Southern California
George Velmahos
Affiliation:
Massachusetts General Hospital, Boston
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Summary

  • Strict antiseptic precautions and personal protective equipment should be used during the procedure. A single dose of prophylactic antibiotics with Cefazolin should be administered before the procedure. There is no need for further prophylaxis.

  • Chest tubes can be inserted with an open or percutaneous dilational technique.

  • The site of insertion is the same for open or percutaneous insertion and for hemothorax or pneumothorax, at the fourth or fifth intercostal space, at the level of the nipple in males.

  • Autotransfusion should be considered in all cases with large hemothoraces.

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Atlas of Surgical Techniques in Trauma , pp. 16 - 22
Publisher: Cambridge University Press
Print publication year: 2020

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