Do junior doctors know where to insert chest drains safely?
BACKGROUND
The safe insertion of a chest drain is a skill doctors across specialties require. Incorrect placement can lead to significant morbidity and even mortality.


METHODS
This audit surveyed junior doctors working in a teaching hospital about their specialty and level of experience with intercostal drains. They were then asked to mark on a photograph where they would insert a chest drain for a pneumothorax in a non-emergency situation.


RESULTS
Of the 55 junior doctors surveyed, 45% were outside the safe area of chest drain insertion as defined by the British Thoracic Society. The most common error was a choice of insertion site too low (24%).


CONCLUSIONS
In this audit 45% of juniors surveyed would have placed a chest drain outside the safe triangle recommended by the British Thoracic Society. The common mistake of a choice of insertion site too low should be discussed in postgraduate teaching programmes.
Department of Cardiothoracic Surgery, Northern General Hospital, University Hospitals Sheffield, Sheffield, UK. jrgriffiths@doctors.org.uk
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JR
Griffiths
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Roberts
D015505:Chest Tubes; D002983:Clinical Competence; D004322:Drainage / Q000379:methods / Q000592:standards*; D004503:Education, Medical, Graduate / Q000592:standards; D004739:England; D006801:Humans; D008485:Medical Audit; D008505:Medical Staff, Hospital / Q000592:standards*; D011030:Pneumothorax / Q000628:therapy; D035441:Thoracic Wall / Q000033:anatomy & histology