Chest tube insertion using image guidanceCChest tube insertion using image guidanceChest tube insertion using image guidanceEnglishOtherChild (0-12 years);Teen (13-18 years)ChestLungsProceduresAdult (19+) CaregiversNA2018-02-08T05:00:00ZDalia Bozic BScN, MN, NP-PHC;Michelle Cote BScN RN;Prakash Muthusami, MD;Joao Amaral, MD7.6000000000000067.90000000000001250.00000000000Health (A-Z) - ProcedureHealth A-Z<p>The pleural space can fill up with fluid or air after an accident or operation or as a result of disease. ​Chest tubes are placed into the pleural space to drain the fluid or air.<br></p><h2>What is a chest tube or pleural drain?</h2><p>A chest tube (pleural drain) is a soft flexible tube placed into the space around the lung, called the pleural space. Chest tubes drain fluid or air that could affect your child's breathing.</p><p>Chest tubes are inserted using ultrasound and X-ray by an interventional radiologist or through surgery.</p> <figure class="asset-c-80"> <span class="asset-image-title">Lung pleura and pleural space</span> <img src="https://assets.aboutkidshealth.ca/akhassets/IMD_pleural_cavity_EN.jpg" alt="Right lung covered with pleura and inside view of left lung" /> <figcaption class="asset-image-caption">The pleura is made up of two thin layers of tissue that cover the lungs and inner chest wall. The space between the two layers is called the pleural space. The pleura aids the lungs during breathing.</figcaption> </figure> <h2>Why is a chest tube needed?</h2><p>After an operation or accident or as a result of disease, the pleural space can fill up with air, blood or fluid. The air or fluid in the pleural space stops the lungs from inflating completely when your child breathes in. As the amount of fluid or air in the pleural space increases it becomes more and more difficult for your child to breathe. The air or fluid needs to be drained away from the pleural space. This is done by inserting a chest tube.</p><h2>Key points</h2><ul><li>A chest tube is inserted between the ribs to drain fluid or air from the pleural space.</li><li>The tube can be placed in the chest using ultrasound and X-ray guidance or through surgery.</li><li>Usually, chest tube insertion is a low risk procedure.</li><li>Removing the chest tube is usually done at the bedside without anaesthetic.</li></ul><br><h2>Your child will have medicine for pain</h2><p>It is important that your child is as comfortable as possible for the procedure. They may be given <a href="/Article?contentid=3001&language=English">local anaesthesia</a>, <a href="/Article?contentid=1260&language=English">sedation</a> or <a href="/Article?contentid=1261&language=English">general anaesthesia</a>. The type of medicine that your child will have for the procedure will depend on your child's age and condition.</p><p>During the chest tube insertion, you will be asked to wait in the surgical waiting room.</p><h2>How a chest tube is inserted</h2> <figure><span class="asset-image-title">Chest tube (pleural drainage)</span><img src="https://assets.aboutkidshealth.ca/akhassets/Chest_tube_IGT_EN.jpg" alt="Chest tube inserted into the pleural space around a deflated lung" /><figcaption class="asset-image-caption">A chest tube is a soft flexible tube placed into the pleural space around the lung. The tube drains fluid or air from the pleural space that is compressing the lung and restricting breathing. </figcaption> </figure> <p>A small incision (cut) is made between the ribs. The interventional radiologist uses ultrasound and a type of X-ray called fluoroscopy to see the tube as it is tunneled under the skin into the pleural space.</p><p>The chest tube is secured with a dressing and a device to protect it and keep it securely in place.</p><p>The tube is connected to a collection container. The collection container needs to be placed below the level of the bed so the air or fluid can drain out. If your child needs suction, then their chest tube may be connected to suction coming from the wall in their room. You may notice a bubbling sound from the suction.<br></p><p>If your child does not need suction for their chest tube, then it will only be connected to a collection container that drains using gravity.</p><p>The tube will need to stay in place until there is little left to drain from the pleural space. Usually your child will need to stay in hospital until the chest tube is removed and the underlying problem is resolved. This varies depending on your child's condition.</p><h2>After the chest tube insertion</h2><p>Once the chest tube insertion is complete, your child will be moved to the recovery area. The interventional radiologist will come and talk to you about the details of the procedure. As soon as your child starts to wake up a nurse will come and get you.</p><p>The interventional radiologist will come to see your child later on to ensure the chest tube is working properly.</p><p>Some children feel local pain or discomfort after the chest tube is placed. The tube is thin, and pain can usually be controlled by pain medicines. Your child will be closely monitored and given pain medicine as needed. After a day, most children feel no pain with the tube.</p><h2>Taking out the chest tube</h2><p>Your child will not need anaesthetic when the chest tube is taken out. The chest tube is usually removed at the bedside, and a sealed dressing is placed over the chest tube site. Your child will not need any stitches.</p><p>The dressing over the chest tube site will stay in place for a few days (at least 48 hours). Your child's doctor will tell you when the dressing can be taken off. You will receive instructions on how to take care of the site.</p><h2>Going home</h2><p>The length of hospital stay will depend on your child's overall health. In most cases, children go home only after the chest tube is removed. Your doctor will let you know when they are well enough to go home.</p><br><h2>Giving consent before the procedure</h2><p>Before the procedure, the interventional radiologist will go over how and why the procedure is done, as well as the potential benefits and risks. They will also discuss what will be done to reduce these risks, and will help you weigh the benefits against the risks. It is important that you understand all of the potential risks and benefits of the chest tube insertion and that all of your questions are answered. If you agree to the procedure, you can give consent for treatment by signing the consent form. A parent or legal guardian must sign the consent form for young children. The procedure will not be done unless you give your consent.</p><h2>How to prepare your child for the procedure</h2><p>Before any treatment, it is important to talk to your child about what will happen. When talking to your child, use words they can understand. Let your child know that medicines will be given to make them feel comfortable during the procedure.</p><p>Children feel less anxious and scared when they know what to expect. Children also feel less worried when they see their parents are calm and supportive.</p><h2>Food, drink, and medicines before the procedure</h2><ul><li>Your child's stomach must be empty before sedation or general anaesthetic.</li><li>If your child has special needs during fasting, talk to your doctor to make a plan.</li><li>Your child can take their regular morning medicine with a sip of water two hours before the procedure.</li><li>Medicines such as <a href="/Article?contentid=77&language=English">acetylsalicylic acid (ASA)</a>, <a href="/Article?contentid=198&language=English">naproxen</a> or <a href="/Article?contentid=153&language=English">ibuprofen</a>, <a href="/Article?contentid=265&language=English">warfarin</a>, or <a href="/Article?contentid=129&language=English">enoxaparin</a> may increase the risk of bleeding. Do not give these to your child before the procedure unless they have been cleared first by their doctor and the interventional radiologist.<br></li></ul><br><p>At SickKids, the interventional radiologists work in the <a target="_blank" href="http://www.sickkids.ca/IGT/index.html">Department of Diagnostic Imaging – Division of Image Guided Therapy (IGT)</a>. For more information on chest tube insertion using image guidance please call the IGT clinic at (416) 813-7654 ext. 202407 and speak to the IGT nurse practitioner during working hours or leave a message with the nurse practitioner.</p><p>For more information on fasting see <a target="_blank" href="http://www.sickkids.ca/VisitingSickKids/Coming-for-surgery/Eating-guidelines/index.html">Eating and drinking before surgery</a>.</p><p>For more information on preparing your child for their procedure see <a target="_blank" href="http://www.sickkids.ca/VisitingSickKids/Coming-for-surgery/index.html">Coming for surgery</a>.</p>

 

 

 

 

Chest tube insertion using image guidance3381.00000000000Chest tube insertion using image guidanceChest tube insertion using image guidanceCEnglishOtherChild (0-12 years);Teen (13-18 years)ChestLungsProceduresAdult (19+) CaregiversNA2018-02-08T05:00:00ZDalia Bozic BScN, MN, NP-PHC;Michelle Cote BScN RN;Prakash Muthusami, MD;Joao Amaral, MD7.6000000000000067.90000000000001250.00000000000Health (A-Z) - ProcedureHealth A-Z<p>The pleural space can fill up with fluid or air after an accident or operation or as a result of disease. ​Chest tubes are placed into the pleural space to drain the fluid or air.<br></p><h2>What is a chest tube or pleural drain?</h2><p>A chest tube (pleural drain) is a soft flexible tube placed into the space around the lung, called the pleural space. Chest tubes drain fluid or air that could affect your child's breathing.</p><p>Chest tubes are inserted using ultrasound and X-ray by an interventional radiologist or through surgery.</p> <figure class="asset-c-80"> <span class="asset-image-title">Lung pleura and pleural space</span> <img src="https://assets.aboutkidshealth.ca/akhassets/IMD_pleural_cavity_EN.jpg" alt="Right lung covered with pleura and inside view of left lung" /> <figcaption class="asset-image-caption">The pleura is made up of two thin layers of tissue that cover the lungs and inner chest wall. The space between the two layers is called the pleural space. The pleura aids the lungs during breathing.</figcaption> </figure> <h2>Why is a chest tube needed?</h2><p>After an operation or accident or as a result of disease, the pleural space can fill up with air, blood or fluid. The air or fluid in the pleural space stops the lungs from inflating completely when your child breathes in. As the amount of fluid or air in the pleural space increases it becomes more and more difficult for your child to breathe. The air or fluid needs to be drained away from the pleural space. This is done by inserting a chest tube.</p><h2>Key points</h2><ul><li>A chest tube is inserted between the ribs to drain fluid or air from the pleural space.</li><li>The tube can be placed in the chest using ultrasound and X-ray guidance or through surgery.</li><li>Usually, chest tube insertion is a low risk procedure.</li><li>Removing the chest tube is usually done at the bedside without anaesthetic.</li></ul><br><h2>Your child will have medicine for pain</h2><p>It is important that your child is as comfortable as possible for the procedure. They may be given <a href="/Article?contentid=3001&language=English">local anaesthesia</a>, <a href="/Article?contentid=1260&language=English">sedation</a> or <a href="/Article?contentid=1261&language=English">general anaesthesia</a>. The type of medicine that your child will have for the procedure will depend on your child's age and condition.</p><p>During the chest tube insertion, you will be asked to wait in the surgical waiting room.</p><h2>How a chest tube is inserted</h2> <figure><span class="asset-image-title">Chest tube (pleural drainage)</span><img src="https://assets.aboutkidshealth.ca/akhassets/Chest_tube_IGT_EN.jpg" alt="Chest tube inserted into the pleural space around a deflated lung" /><figcaption class="asset-image-caption">A chest tube is a soft flexible tube placed into the pleural space around the lung. The tube drains fluid or air from the pleural space that is compressing the lung and restricting breathing. </figcaption> </figure> <p>A small incision (cut) is made between the ribs. The interventional radiologist uses ultrasound and a type of X-ray called fluoroscopy to see the tube as it is tunneled under the skin into the pleural space.</p><p>The chest tube is secured with a dressing and a device to protect it and keep it securely in place.</p><p>The tube is connected to a collection container. The collection container needs to be placed below the level of the bed so the air or fluid can drain out. If your child needs suction, then their chest tube may be connected to suction coming from the wall in their room. You may notice a bubbling sound from the suction.<br></p><p>If your child does not need suction for their chest tube, then it will only be connected to a collection container that drains using gravity.</p><p>The tube will need to stay in place until there is little left to drain from the pleural space. Usually your child will need to stay in hospital until the chest tube is removed and the underlying problem is resolved. This varies depending on your child's condition.</p><h2>After the chest tube insertion</h2><p>Once the chest tube insertion is complete, your child will be moved to the recovery area. The interventional radiologist will come and talk to you about the details of the procedure. As soon as your child starts to wake up a nurse will come and get you.</p><p>The interventional radiologist will come to see your child later on to ensure the chest tube is working properly.</p><p>Some children feel local pain or discomfort after the chest tube is placed. The tube is thin, and pain can usually be controlled by pain medicines. Your child will be closely monitored and given pain medicine as needed. After a day, most children feel no pain with the tube.</p><h2>Taking out the chest tube</h2><p>Your child will not need anaesthetic when the chest tube is taken out. The chest tube is usually removed at the bedside, and a sealed dressing is placed over the chest tube site. Your child will not need any stitches.</p><p>The dressing over the chest tube site will stay in place for a few days (at least 48 hours). Your child's doctor will tell you when the dressing can be taken off. You will receive instructions on how to take care of the site.</p><h2>Going home</h2><p>The length of hospital stay will depend on your child's overall health. In most cases, children go home only after the chest tube is removed. Your doctor will let you know when they are well enough to go home.</p><br><h2>Giving consent before the procedure</h2><p>Before the procedure, the interventional radiologist will go over how and why the procedure is done, as well as the potential benefits and risks. They will also discuss what will be done to reduce these risks, and will help you weigh the benefits against the risks. It is important that you understand all of the potential risks and benefits of the chest tube insertion and that all of your questions are answered. If you agree to the procedure, you can give consent for treatment by signing the consent form. A parent or legal guardian must sign the consent form for young children. The procedure will not be done unless you give your consent.</p><h2>How to prepare your child for the procedure</h2><p>Before any treatment, it is important to talk to your child about what will happen. When talking to your child, use words they can understand. Let your child know that medicines will be given to make them feel comfortable during the procedure.</p><p>Children feel less anxious and scared when they know what to expect. Children also feel less worried when they see their parents are calm and supportive.</p><h2>Food, drink, and medicines before the procedure</h2><ul><li>Your child's stomach must be empty before sedation or general anaesthetic.</li><li>If your child has special needs during fasting, talk to your doctor to make a plan.</li><li>Your child can take their regular morning medicine with a sip of water two hours before the procedure.</li><li>Medicines such as <a href="/Article?contentid=77&language=English">acetylsalicylic acid (ASA)</a>, <a href="/Article?contentid=198&language=English">naproxen</a> or <a href="/Article?contentid=153&language=English">ibuprofen</a>, <a href="/Article?contentid=265&language=English">warfarin</a>, or <a href="/Article?contentid=129&language=English">enoxaparin</a> may increase the risk of bleeding. Do not give these to your child before the procedure unless they have been cleared first by their doctor and the interventional radiologist.<br></li></ul><br><h2>Risks of chest tube insertion</h2><p>Chest tube insertion is usually considered a low-risk procedure. The risk may increase depending on your child's condition, age and health.</p><p>The risks of a chest tube include:</p><ul><li>pain or discomfort</li><li>leakage of air back into the pleural space</li><li>infection</li><li>worsening breathing problems</li></ul><br><p>At SickKids, the interventional radiologists work in the <a target="_blank" href="http://www.sickkids.ca/IGT/index.html">Department of Diagnostic Imaging – Division of Image Guided Therapy (IGT)</a>. For more information on chest tube insertion using image guidance please call the IGT clinic at (416) 813-7654 ext. 202407 and speak to the IGT nurse practitioner during working hours or leave a message with the nurse practitioner.</p><p>For more information on fasting see <a target="_blank" href="http://www.sickkids.ca/VisitingSickKids/Coming-for-surgery/Eating-guidelines/index.html">Eating and drinking before surgery</a>.</p><p>For more information on preparing your child for their procedure see <a target="_blank" href="http://www.sickkids.ca/VisitingSickKids/Coming-for-surgery/index.html">Coming for surgery</a>.</p>https://assets.aboutkidshealth.ca/AKHAssets/Chest_tube_IGT_EN.jpgChest tube insertion using image guidanceFalse