Steps Involved In Chest Tube Insertion

A chest tube can be a relatively non-invasive way to access the pleural space to drain fluid or administer medication. A doctor may put a person under general anesthesia for a chest tube insertion.

Due to technological advances in the medical field, doctors are able to obtain precise, objective, digital data for better clinical decisions in this complex thoracic surgery procedure.

There are different incision approaches for inserting the chest tube, but the procedure will follow the same essential steps:

  • Elevating the head of a person’s bed by 30–60 degrees. Someone will usually raise the arm on the affected side above the head.
  • Identifying the tube insertion site. This will typically be between the fourth and fifth ribs or between the fifth and sixth ribs, just behind the pectoralis (chest) muscle.
  • Cleaning the skin with a solution, such as povidone-iodine or chlorhexidine. Doctors will allow the skin to dry before placing a sterile drape over the patient.
  • Using local anesthetic to numb the insertion site. Once the area is completely numb, a doctor may insert a needle more deeply to see if they can pull back fluid or air. This will confirm that they are in the right area.
  • Make an incision of about 2–3 centimeters (cm) through the skin. Using a surgical instrument called a Kelly clamp, the doctor will widen the incision and gain access to the pleural space. The clamp insertion should be slow to avoid puncturing the lung.