title: Chest drain insertion is not a harmless procedure--are we doing it safely?
abstract: The incorrect insertion of a chest drain can cause serious harm or even death. All elective drains should be inserted in the 'triangle of safety' in line with the British Thoracic Society guidelines. The aim of this study was to test the awareness of junior doctors involved in inserting chest drains with these guidelines. Fifty junior doctors were questioned. Participants were asked to grade their experience of chest drain insertion and mark on a diagram where they felt was the optimum site for inserting a drain for a large pneumothorax in an elective situation. Only 44% (n=22) of doctors indicated they would insert a chest drain within the safe triangle. Level of experience, seniority and specialty all had an effect on knowledge of the correct site. Of those who had inserted drains unsupervised, 48% (n=16) would site the drain outside the safe triangle as would 75% (n=6) of those who had performed the procedure supervised. Only 25% of medics knew where to insert a drain, compared with 58% of doctors working in surgery. The majority of junior doctors do not have the basic knowledge to insert a chest drain safely. Further training in this procedure is needed for junior doctors.
authors.affiliation: Department of Cardiothoracic, Liverpool Heart and Chest Hospital, Thomas Drive, Liverpool L14 3PE, UK. drhany.elsayed@yahoo.co.uk
authors.forename: Hany
authors.initials: H
authors.lastname: Elsayed
authors.forename: Rebecca
authors.initials: R
authors.lastname: Roberts
authors.forename: Mehrdad
authors.initials: M
authors.lastname: Emadi
authors.forename: Ian
authors.initials: I
authors.lastname: Whittle
authors.forename: Michael
authors.initials: M
authors.lastname: Shackcloth
mesh_terms: D001364:Awareness; D015505:Chest Tubes; D002983:Clinical Competence; D004322:Drainage / Q000009:adverse effects* / Q000295:instrumentation / Q000379:methods; D004503:Education, Medical, Graduate; D017558:Elective Surgical Procedures; D004739:England; D019983:Guideline Adherence; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007442:Intubation, Intratracheal / Q000009:adverse effects* / Q000295:instrumentation; D008505:Medical Staff, Hospital; D011030:Pneumothorax / Q000601:surgery*; D017410:Practice Guidelines as Topic; D018570:Risk Assessment; D012307:Risk Factors