Positioning

Before proceeding you will need to position your patient appropriately and mark the site of insertion.

The ideal position of your patient is lying flat or at 45 degrees, with their hand behind head, or abducted to 90 degrees if they are unconscious. Alternatively, a conscious patient may lean forward against a trolley table.

You can then begin to mark the point of insertion.

The most common cause of serious chest drain related injury is insertion at the wrong site, usually too low.

Key points in the procedure

• Find the second intercostal space
• Count down to fifth intercostal space
• Slide finger laterally in this space, to the mid-axillary line
• Mark the site