The skills for insertion and removal of an intercostal drain are invaluable for the junior clinician especially in an unstable trauma setting and a tension pneumothorax.
Learn how to perform a chest drain insertion and removal by seamlessly moving between the learning media; text, video, anatomy and simulator. In the simulator, learn how to perform a chest drain insertion and removal in learn mode or test yourself in test mode by choosing medical tools with your computer mice and performing the procedure in a virtual environment. In test mode you may also choose multi-choice questions to test your understanding. Examine your performance in either mode in your personalized logbook and print this record for your own documentation.
Read a concise step-by-step description of how to perform the insertion and removal of an intercostal drain with the mattress suture and simple techniques. Steps are based upon evidence-based medicine and have hyperlinks to the relevant abstracts in Pubmed. Watch the procedure performed by an expert and observe how to correctly identify the 5th intercostal space and the midaxillary line. Rotate and zoom a segment of the chest wall to review the local anatomy and illustrate the relationships of the intercostal muscle, rib and neurovascular bundle.
In the simulator, train yourself to insert a chest or pleural drain by either technique. Position the patient in the correct position - in a supine position and raised at 45 degrees with the ipsilateral arm raised up over the head. Learn when and how to mark the insertion site, infiltrate the local anestheisa, make a skin incision with a scalpel, suture the chest wall (mattress technique or simple technique), secure the chest drain, attach the drainage device, and remove the clamp from the chest drain.
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