RT Journal Article
SR Electronic
T1 Chest drain insertion and complications in a hospital in the Northwest of England
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP P3362
VO 42
IS Suppl 57
A1 William Falconer
A1 Andrew Disney
A1 Simon Twite
A1 Paul Stockton
YR 2013
UL http://erj.ersjournals.com/content/42/Suppl_57/P3362.abstract
AB IntroductionIntercostal chest drain insertion is a common yet potentially hazardous procedure within Respiratory practice. In 2008 the UK National Patient Safety Agency reported deaths and serious harm related to their use. Documentation of written consent and pleural ultrasound prior to draining fluid were specific areas highlighted for improvement.AimsWe aimed to establish which clinicians insert chest drains, if written consent is being obtained, if pleural ultrasound is being used and the complication rates within our hospital.MethodologyA retrospective analysis of 76 clinical records of patients who had chest drain procedures between April 2011 - December 2012 was conducted. Data was collected regarding consent, ultrasound imaging, insertion of drain and complications.ResultsIndications for chest drain insertion: pleural effusion 53%, spontaneous pneumothorax 29%, empyema 5%, traumatic haemothorax 5%, traumatic pneumothorax 5% and post-aspiration pneumothorax 1%.There was evidence of documented written consent in 39%, no written evidence in 42% and documented emergency reason for no written consent in 18%.Senior House Officers inserted 49% of drains, Registrars 37%, Consultants 9%, House Officers 3%.Thoracic ultrasound was performed in 78% of cases requiring fluid drainage. 78% had Seldinger drain insertion, 13% surgical drains and 9% not documented.41% of drains developed complications. Drain falling out was the commonest in 13%.ConclusionsA significant number of drains were inserted without written consent (42%) or prior ultrasound (28%). 41% of drains were associated with complications although none were life threatening. We plan to arrange further training amongst junior doctors.