UWMC Procedures Page

This excellent resource from the UWMC's Division of Emergency Medicine has multiple procedures all available from a central page based on FLASH. (needs flash player).

http://depts.washington.edu/emed/procedures/index.swf

Chest Tubes (NEJM Video)

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The insertion of a pleural chest tube is often done in a setting where immediate action is required. Nonetheless, adherence to sterility, analgesia, sound technique, and safety are always warranted. Indications The most common indications for chest-tube drainage are: Pneumothorax that is recurrent, persistent, under tension, or bilateral; any pneumothorax in a patient on positive-pressure ventilation; hemothorax; recurrent or symptomatic large pleural effusion; empyema; and chylothorax. Contraindications There are relative contraindications, mainly based on hematologic abnormalities such as bleeding diatheses or coagulopathy. Blood products or coagulation factors may need to be transfused in order to reduce the . . . . View Video Chapters: Overview Indications Contraindications Equipment Landmarking Anesthetizing Tissues Incision and Dissection Securing the Tube Pleural Drainage Systems Complications Removing the Tube