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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 ...
After these stabilizing measures, further treatment depends on the cause. Treatment of the underlying condition can quickly resolve the shock. For tension pneumothorax, needle decompression should be done immediately. A chest tube is also inserted. [3] [8] Cardiac tamponade is treated through needle or surgical decompression. [3]
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 ...
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 ...
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.
For experienced clinicians, the incidence of pneumothorax is about 1.5–3.1%. The National Institute for Health and Care Excellence (UK) and other medical organizations recommend the routine use of ultrasonography to minimize complications. [5] If a pneumothorax is suspected, an upright chest x-ray should be obtained. An upright chest x-ray is ...
In modern portable, digital chest drainage systems, the collection chamber is integrated into the system. During the suction process, fluid will be collected in the chamber and air discharged into the atmosphere. [2] Digital chest drainage systems have many advantages compared to traditional, analogue systems:
A thoracostomy tube can be used to remove blood and air from the chest cavity. [21] About 5% of cases require surgery, called thoracotomy . [ 11 ] Thoracotomy is especially likely to be needed if a lung fails to re-expand; if pneumothorax, bleeding, or coughing up blood persist; or in order to remove clotted blood from a hemothorax. [ 11 ]