A chest tube is a thin, plastic tube that a doctor inserts into the pleural space, which is the area between the chest wall and the lungs.
Doctors may need to use a chest tube for many purposes, such as inflating a collapsed lung, draining fluid or blood, or delivering medications.
A doctor may put a person under general anesthesia for a surgical chest tube drainage insertion. Alternatively, they will use a local anesthetic to numb the area before inserting the tube and will also provide the person with sedation and pain medications.
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.
- Inserting the chest tube through the incision site. If fluid begins to drain through the tube, it is in the right place. It is also possible to attach the tube to a chamber containing water that moves when a person breathes. If this does not occur, the tube may need repositioning.