Sponges for preparation of the site.
2 large, curved, Kelly clamps.
6 x 10 millimeter syringes with number 18 and number 25 gauge
Scalpel and blade.
One percent lidocaine.
Suture (to secure the chest tube).
Suture (for wound approximation).
Appropriate chest tube size.
(11) Sterile surgical gloves.
(12) Occlusive dressing material.
(13) Sterile drape.
(14) Needle holder.
c. Procedure for Chest Tube Insertion. Monitor the patient throughout the
procedure. Follow these steps:
Put on the gloves and mask.
(2) Determine the placement site. For a patient with hemothorax, the site is
about nipple level (the 5th intercostal space) on his affected side. For a patient with
pneumothorax, the site is usually the second intercostal space, midclavicular line.
Prepare and drape the patient.
(4) Locally, anesthetize the skin and rib periosteum, if the patient's condition
and time permit.
(5) Incise the skin, creating a tunnel. Using a scalpel and blade, make a
two to three centimeter transverse incision through the subcutaneous tissues, just over
the top of the rib. Create a tunnel by spreading the clamp.