Surgical Chest Tube Procedure Note [.phrase]

Surgical Tube Thoracostomy

Indication: *** Tension pneumothorax with cardiac arrest.

Operator: Castaneda

Patient was in cardiac arrest at the time of this procedure. The procedure was emergent. The patient’s LEFT/RIGHT chest was prepped. A 6 cm skin incision was made in the anterior-axillary line. The tract was dilated with kelly forceps and the subcutaneous tissue superficial and superior to the rib was dissected bluntly to the level of the pleura. The pleura was then entered bluntly. Rush of air was noted from the pleural space. The disruption in the parietal pleura was expanded bluntly and a finger was inserted and swept carefully in all directions. A 32 French chest tube was then inserted using my finger as a guide. The chest tube was directed anteriorly and inserted easily. The chest tube was sutured to the skin at the insertion site, and connected securely to a pleurovac. A sterile occlusive dressing was placed over the insertion site.

The patient immediately regained ROSC post insertion.

A post-procedure chest x-ray showed re-expansion of the lung with inferior course of the tube. Estimated blood loss is 10ccs