Behind the knife

Easily place a chest tube (tube thoracostomy) no matter the situation! Patients with pneumothorax or fluid in the chest (pleural effusion, hemothorax, empyema) may benefit from chest tubes. If you like this content, be sure to check out the other videos in this BEDSIDE PROCEDURES SERIES - https://app.behindtheknife.org/video-playlists/bedside-procedures
Follow us on Twitter! @BehindTheKnife https://twitter.com/behindtheknife?lang=en Follow us on Instagram! @behindtheknife_surgerypodcast https://www.instagram.com/behindtheknife_surgerypodcast/ Follow us on Facebook! https://www.facebook.com/behindtheknife/ Intro: (0:00) Gathering Supplies: (0:24) Preparation and Positioning: (2:25) Procedural Steps: (5:19) Outro: (10:05) Supplies you should gather: Mayo stand Knife (15 blade preferred) Chest tube (consider 28F for general purposes) Water seal / suction chamber (i.e. Atrium or Pleur-Evac) 2x pairs of Kelly clamps (or similar) Gauze Suture and needle drivers Sterilizing prep (i.e. chlorhexidine) and drape (consider thyroid drape) Local anesthesia and syringe with needles Preparation Tips and Tricks: Position the bed flat and elevated to your working height Slide the patient to the edge you are working on Open your equipment in a sterile fashion; consider how much help you have Don't forget to set up the Atrium including the water seal chamber Clamp the extracorporeal end of the chest tube Key Steps of the Procedure: Infiltrate local anesthesia Make 2-3 cm incision in the 4th or 5th intercostal space at the midaxillary line Use Kellys to navigate above the rib and punch through the parietal pleura Spread the tract generously, then perform a finger sweep Guide chest tube into the pleural cavity with the Kellys Suture the chest tube in place and dress it Hook up the chest tube to the Atrium, apply suction, and get a chest x-ray. -~-~~-~~~-~~-~- Please watch: "How to Do a Central Line (Central Venous Catheter) - Behind the Knife - Bedside Procedures Episode 2 " https://app.behindtheknife.org/video/easy-central-line-placement-central-venous-catheter-behind-the-knife-bedside-procedures-ep-2 -~-~~-~~~-~~-~- Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.