[Chest drains in trauma patients].
Adequate training for the insertion of chest drains in a trauma setting reduces the occurrence of procedure-related complications. Prophylactic antibiotics reduce the risk of infectious complications and empyema. For drainage of a traumatic pneumo- or haemothorax a large drain (28-36 French) is advised. The preferential insertion site is the 5th intercostal space in the midaxillary line. Drainage systems consist of a collection bottle, water seal and a suction control. Suction applied at 15-20 cm H2O is recommended for adequate drainage. Conversion to thoracotomy is determined by the drain production. Occult air leaks before removal of the drain can be detected by a temporary water seal or by clamping the drain followed by a chest X-ray. Removal of a chest drain at end-inspiration is as secure as end-expiration. Attention must be paid to potential complications of chest drains.
IJpma
Frank F A
FF
Isala klinieken, locatie Sophia, afd. Heelkunde, Zwolle, The Netherlands. f.f.a.ijpma@isala.nl
van Westreenen
H L  Erik
HL
van Acker
Gijs J D
GJ
D015505:Chest Tubes; D020878:Device Removal; D004322:Drainage / Q000295:instrumentation* / Q000379:methods*; D006491:Hemothorax / Q000601:surgery; D006801:Humans; D011030:Pneumothorax / Q000601:surgery; D013902:Radiography, Thoracic; D013396:Suction; D013898:Thoracic Injuries / Q000601:surgery*; D013908:Thoracotomy