Inserting a Chest Drain

A chest tube (chest drain, thoracic catheter, tube thoracostomy, or intercostal drain) is a flexible plastic tube that is inserted through the chest wall and into the pleural space or mediastinum. It is used to remove air (pneumothorax) or fluid (pleural effusion, blood, chyle), or pus (empyema) from the intrathoracic space. It is also known as a Blau drain or an intercostal catheter.

The concept of chest drainage was first advocated by Hippocrates when he described the treatment of empyema by means of incision, cautery, and insertion of metal tubes.

When your chest tube is inserted, you will lie on your side or sit partly upright, with one arm over your head.
  • The area where the tube will be inserted is numbed. Sometimes you will receive medicine through a vein (intravenous, or IV) to make you relaxed and sleepy.
  • Your skin where the tube will be inserted will be cleaned.
  • The chest tube is inserted through a 1-inch cut in your skin between your ribs. Then it is guided to the correct spot.
  • The tube is connected to a bottle or canister. Suction is often used to help it drain. Other times, gravity alone will allow it to drain.
  • A stitch (suture) and tape keep the tube in place.
  • After your chest tube insertion, you will have a chest x-ray to make sure the tube is in the right place.

The chest tube usually stays in place until x-rays show that all the blood, fluid, or air has drained from your chest and your lung has fully re-expanded. The tube is easy to remove when it is no longer needed. Most people do not need medicine to relax or to numb the area when it is removed.