Name: Tube thoracostomy

Description: Tube thoracostomy

Thumbnail URL: https://cadmoremediastorage.blob.core.windows.net/e7a22bd9-c239-484a-b694-a543da983be7/thumbnails/e7a22bd9-c239-484a-b694-a543da983be7.jpg?sv=2019-02-02&sr=c&sig=8drlnbXKRily%2BkLEyMhIyTog0ex2CvcQovKMW%2FZq7rQ%3D&st=2022-07-03T17%3A43%3A09Z&se=2022-07-03T21%3A48%3A09Z&sp=r

Duration: T00H04M34S

Embed URL: https://stream.cadmore.media/player/e7a22bd9-c239-484a-b694-a543da983be7

Content URL: https://asa1cadmoremedia.blob.core.windows.net/asset-f34cd595-5ad8-4ffd-b442-f38980d9d4a5/Tube20thoracostomy.mov

Upload Date: 2022-02-27T00:00:00.0000000

Transcript: Language: EN.
Segment:1 Introduction.
The indication for chest tube insertion in this patient is a large right pleural effusion.
Segment:2 Site Selection.
The chest tube will be inserted in the mid axillary line in the fifth or sixth intercostal space.
Segment:3 Skin Preparation.
The site is widely prepped with a topical iodine-containing solution.

Segment:4 Site Draping.
The site is circumferentially draped. The drapes are replaced widely around the area so as to avoid contamination of the chest tube during insertion.
Segment:5 Anesthesia.
The operator palpates the site to identify the intercostal space and then anesthetizes both the skin and the periosteum with a local anesthetic solution. The operator infiltrates the skin, subcutaneous tissue, and the periosteum with approximately 10 cc of a 1% solution lidocaine.

Segment:6 Incision and Dissection.
The operator makes an approximately 2 centimeter incision with a scalpel and then dissects the tissue along the track into the intercostal space with a Kelly clamp.
The subcutaneous tissue, external and internal intercostal muscles are spread widely. The tip of the clamp is then walked over the ribbon, the lower portion of the intercostal space, and popped through the pleura, which is also spread widely.
Segment:7 Chest Tube Insertion.
The operator's index finger is used for further blunt dissection and to explore the interthoracic space to ensure that there are no adhesions.
The chest tube is then inserted with the Kelly clamp into the pleura. And in this case, you can see fluid draining through the chest tube.
Segment:8 Securing Tube.
The chest tube is then sewn in place with sutures at the skin so as to ensure that the chest tube does not move back and forth with manipulation.

Segment:9 Chest Tube Drainage System.
Finally, the chest tube is attached to a pleural fluid drainage container. This container has drainage, suction control in the upper left, and a water seal in the lower left.

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