TY - JOUR T1 - Safer intercostal drain (ICD) insertions JF - European Respiratory Journal JO - Eur Respir J VL - 38 IS - Suppl 55 SP - p604 AU - Phong Teck Lee AU - Thomas Hartung Y1 - 2011/09/01 UR - http://erj.ersjournals.com/content/38/Suppl_55/p604.abstract N2 - Introduction: Intercostal chest drain (ICD) insertion carries a small but significant risk to patients when not performed properly. We re-audited the practice of ICD insertion in our hospital following several implementations since a previous audit in 2007-08. These implementations include drain insertion in specialised areas i.e. respiratory unit treatment room, strict sterility, ultrasound guidance, insertion sticker check list and nursing care plan.Results: There were a total of 31 patients (15 males) in the bi-monthly audit from March '09 to January '10. Majority of the ICD insertions (87%) were performed in the respiratory unit and ultrasound guidance was documented in only 41.9%. ICD stickers were used in 83.9% and nursing care plan in 77.4%. Excluding the adverse event “pain”, complications rates in our hospital decreased from 39% to 12.9% in 2009-10 (Table 1). This is comparable with the complication rates of other centres (11-37%) [1]. Adverse events were significantly higher when drains were inserted outside a respiratory unit (p=0.007). Surprisingly, we found no statistical differences between complication rates and the use of ultrasound guidance; sticker check list; or nursing care plan.View this table:Table 1. Complication rates excluding painConclusion: ICD insertion is advised to be performed in a specialised unit by staff with relevant competencies under adequate supervision.References:1. Horsley A, Jones L, White J et al. Efficacy and Complications of Small-Bore, Wire-Guided Chest Drains. Chest. 2006;130:1857-1863. ER -