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Chest Tube Placement

Chest tube placement is a minimally-invasive procedure (small incisions of 2–3 inches long / local anesthesia) performed to treat and prevent pleural effusions. Pleural effusion is a condition that causes excess fluid buildup in the lungs, specifically the pleura. The pleura is a thin membrane covering the surface of the lungs and chest wall. Some fluid is always found here, but the amount should be no more than a few teaspoons. Pleural effusion does not always cause problems, but severe cases can result in inflammation and difficulty breathing.

Chest tube placement involves the insertion of a thin plastic tube into the pleural space. The tube may be attached to a suction device to remove excess fluid or air. Or, it may be used in a procedure called pleurodesis in which medication is delivered into the space to decrease the likelihood that fluid will accumulate.

How to prepare for the procedure

Prior to the procedure, your doctor and treatment team will explain to you what to expect before, during and after the procedure and potential risks of the procedure. Other recommendations include:

Talk to your doctor about

  • All medications, herbal products and dietary supplements you are currently taking and ask for their recommendations about each.
  • Radiation exposure, especially for those that are pregnant
  • Any allergies to medicines, latex, tape, iodine, and anesthetic agents
  • Any history of bleeding disorders
  • Any body piercings on your chest or abdomen

Other suggestions

  • Eat a normal meal the evening before the procedure. However, do not eat, drink or chew anything after midnight before your procedure. If you must take medications, only take them with sips of water.
  • Leave all jewelry at home
  • Remove all makeup and nail polish
  • Wear comfortable clothing when you come to the hospital.
  • If you normally wear dentures, glasses, or hearing devices at home, plan to wear them during the procedure.

What to expect before the procedure

To determine whether you need this procedure, your doctor might perform a variety of tests, including:

Diagnostic tests and procedures

What to expect during the procedure

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A chest tube placement procedure will typically take between 15 to 30 minutes to complete. This procedure is typically performed bedside and occasionally in the operating room (OR). Check with your doctor about the details of your procedure. In general:

  • You will change into a hospital gown.
  • A nurse will start the intravenous (IV) line in your arm which will administer medications, fluids and a sedative.
  • Your doctor will use a local anesthetic to numb the area of your chest where the incision will be made.
  • The doctor will make a small incision and insert a chest tube. Then the fluid will be drained into a collection device.
  • Once the fluid has been drained, talc powder, doxycycline, or another medicine may be injected into the pleural space through the chest tube. The medicine will coat the outside of your lung and create a sticky surface that makes it adhere to the chest wall.
  • Your doctor might do an X-ray to confirm that the procedure was successful.
  • When the chest tube is no longer needed, your doctor will loosen the suture or tape, you will take a deep breath and the tube will be removed. The area may be sutured and a special bandage applied.

What to expect after the procedure

After the procedure, you will be taken to the recovery room for 1 to 2 days. Other recommendations include:

General guidelines

  • You may be given antibiotics and pain medication.
  • You should change positions often while lying down, and exercise if possible.
  • Keep the skin around where the chest tube is inserted clean and dry.
  • Take regular deep breaths followed by a cough.
  • Maintain the drainage system as instructed, keeping it below chest level.
  • Receive several different medicines to relieve pain. Patients will be given long-acting oral pain medication, NSAIDS, IV pain medication and multi-level intercostal nerve blocks.
  • Your doctor will give you instructions to follow during your recovery.
Saint Barnabas Medical Center
94 Old Short Hills Road
Livingston, NJ 07039
(973) 322-5000
Monmouth Medical Center
300 Second Avenue
Long Branch, NJ 07740
(732) 222-5200
Community Medical Center
99 Highway 37 West
Toms River, NJ 08755
(732) 557-8000
Newark Beth Israel Medical Center
201 Lyons Avenue at Osborne Terrace
Newark, NJ 07112
(973) 926-7000
Jersey City Medical Center
355 Grand Street
Jersey City, NJ 07302
(201) 915-2000
Robert Wood Johnson University Hospital
1 Robert Wood Johnson Place
New Brunswick, NJ 08901
(732) 828-3000

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