Chest tube placement, care, and removal

Most commonly undertaken to treat one of the following conditions:

• Pneumothorax

• Pleural fluid collection

  • Hemothorax

  • Simple effusion

  • Empyema

Can be both a diagnostic and a therapeutic maneuver

In an emergent situation (i.e., tension pneumothorax), there are no contraindications

In a nonurgent situation, caution should be exercised in the presence of:

• Known or suspected adhesions

  • Prior chest surgery or trauma

  • History of pleural space infection

  • Intrinsic parenchymal disease

• Complex, loculated air or fluid collection(s)

  • Typically noted on imaging studies

In situations where insertion is not emergent and is anticipated to be difficult, consideration is recommended for placement by a skilled operator (surgeon) or under image guidance (computed tomography [CT], ultrasound)