What is a tube thoracostomy?

Updated: Feb 24, 2020
  • Author: Gil Z Shlamovitz, MD, FACEP; Chief Editor: Nader Kamangar, MD, FACP, FCCP, FCCM  more...
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Tube thoracostomy is the insertion of a tube (chest tube) into the pleural cavity to drain air, blood, bile, pus, or other fluids. [5] Whether the accumulation of air or fluid is the result of rapid traumatic filling with air or blood or an insidious malignant exudative fluid, placement of a chest tube allows for continuous, large volume drainage until the underlying pathology can be more formally addressed. The list of specific treatable etiologies is extensive (see Indications), but without intervention, patients are at great risk for major morbidity or mortality.

Editor's note: Targeted guidewire and trocar-guided placement are other techniques that are used; however, these are considered high risk for complications in the emergency department setting. Therefore, the classic technique described in this article is the highly recommended one for emergency department thoracostomy tube placement. Additionally, using ultrasound to assess tube placement is an emerging technology; however, chest radiography is the current criterion standard of care, as studies have not yet proven ultrasound to be safer or superior to radiography. For further information on other techniques see Medical Thoracoscopy and Tube Thoracostomy Management.

Also see the BTS Pleural Disease Guideline 2010. [6]

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