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A thoracostomy is a small incision of the chest wall, [1] with maintenance of the opening for drainage. [2] It is most commonly used for the treatment of a pneumothorax.This is performed by physicians, paramedics, and nurses usually via needle thoracostomy or an incision into the chest wall with the insertion of a thoracostomy tube (chest tube) or with a hemostat and the provider's finger ...
Chest tubes are also provided in right angle, trocar, flared, and tapered configurations for different drainage needs. As well, some chest tubes are coated with heparin to help prevent thrombus formation, though the effect of this is disputed. [16] Chest tube have an end hole (proximal, toward the patient) and a series of side holes.
A chest tube (or intercostal drain) is the most definitive initial treatment of a pneumothorax. These are typically inserted in an area under the axilla (armpit) called the " safe triangle ", where damage to internal organs can be avoided; this is delineated by a horizontal line at the level of the nipple and two muscles of the chest wall ...
The end of the drainage tube is placed inside the chest cavity of the patient — into the air mass or into the fluid mass to be drained from the thorax. The flutter valve is placed in the appropriate orientation (designed so that the valve can only be connected in the appropriate orientation) and the pneumothorax is thus evacuated from the ...
As with other chest injuries such as pulmonary contusion, hemothorax, and pneumothorax, pulmonary laceration can often be treated with just supplemental oxygen, ventilation, and drainage of fluids from the chest cavity. [20] A thoracostomy tube can be used to remove blood and air from the chest cavity. [21]
Treatment for this condition is the same as for hemothorax and pneumothorax independently: by tube thoracostomy, the insertion of a chest drain through an incision made between the ribs, into the intercostal space. A chest tube must be inserted to drain blood and air from the pleural space so it can return to a state of negative pressure and ...
Sketch depicting a chest drainage in course. Chest drains are surgical drains placed within the pleural space to facilitate removal of unwanted substances (air, blood, fluid, etc.) in order to preserve respiratory functions and hemodynamic stability.
Air is trapped in the chest cavity outside the lungs (pneumothorax) in about 70% of TBI. [4] [10] Especially strong evidence that TBI has occurred is failure of a pneumothorax to resolve even when a chest tube is placed to rid the chest cavity of the air; it shows that air is continually leaking into the chest cavity from the site of the tear. [11]