QS Study

Tube Thoracostomy

The preferred insertion site for a tube thoracostomy is the fourth or fifth intercostal space at the anterior axillary line. The tube is introduced through a small incision. It is the insertion of a tube (chest tube) into the pleural cavity to drain air, blood, bile, pus, or other fluids. It can help drain air, blood, or fluid from the space surrounding your lungs, called the pleural space. The neurovascular bundle changes its relationship to the ribs as it passes forward in the intercostal space. In the most posterior part of the space, the bundle lies in the middle of the intercostals space. As the bundle passes forward to the rib angle, it becomes closely related to the lower border of the rib above and maintains that position as it courses forward.

Tube Thoracostomy 1

Fig: Tube Thoracostomy anatomical structure

Tube Thoracostomy is the insertion of a tube into the pleural space to drain air or fluid from the chest. The introduction of a thoracostomy tube or needle through the lower intercostal spaces is possible provided that the presence of the domes of the diaphragm is remembered as they curve upward into the rib cage as far as the fifth rib (higher on the right). Avoid damaging the diaphragm and entering the peritoneal cavity and injuring the liver, spleen, or stomach. Tube Thoracostomy is often used to treat pleural effusion, pneumothorax, hemothorax, hemopneumothorax, and empyema. Equipment consists of a sterile set of instruments, local anesthetic, suture material to fix the tube, a chest tube or catheter, a collection device, which includes a water seal (or dry equivalent), and dressings.

Related Study: