University:
Western Sydney University
Course:
MEDI 2003 | Clinical Sciences 2
Academic year:

2024
Views:

400

Pages:

2
Author:

Mariam A.

Principles of Intercostal Catheter (Chest Tube) An intercostal catheter, commonly referred to as a chest tube, is a crucial medical device used to manage various thoracic conditions by draining air, blood, or other fluids from the pleural space. Here are the principles, appropriate sites for placement, indications, contraindications, and possible complications associated with intercostal catheters: Principles of Intercostal Catheter 1. Purpose: To evacuate air or fluid from the pleural cavity, allowing re-expansion of the lung and restoration of negative intrathoracic pressure. 2. Components: Consists of a hollow plastic tube (catheter), drainage system (collection chamber with water seal and suction control), and connectors. 3. Placement: Typically inserted in the pleural space through a surgical incision between the ribs (intercostal space) under sterile conditions. Appropriate Sites for Placement 1. Anterior Placement: Typically between the 4th and 5th intercostal spaces in the midclavicular line. 2. Lateral Placement: Between the 5th and 6th intercostal spaces in the mid-axillary line. 3. Posterior Placement: Between the 8th and 9th intercostal spaces in the mid-scapular line. This site is used for draining fluid from the lower parts of the chest. Indications for Intercostal Catheter Placement 1. Pneumothorax: To evacuate air from the pleural cavity and allow the lung to reexpand. 2. Hemothorax: To drain blood accumulating in the pleural space, often due to trauma or surgery. 3. Pleural Effusion: To drain excess fluid (e.g., due to infection, cancer, or heart failure) from the pleural cavity. 4. Empyema: To drain infected fluid (pus) from the pleural space. Contraindications 1. Coagulopathy: Increased risk of bleeding complications during placement. 2. Uncorrected Hypoxemia: Inadequate oxygenation status may worsen with the procedure. 3. Severe Chest Wall Infection: Increases the risk of introducing infection into the pleural space. Possible Complications 1. Bleeding: Hemorrhage can occur during insertion or due to damage to intercostal vessels. 2. Pneumothorax: Accidental puncture of the lung tissue during insertion. 3. Infection: Risk of introducing bacteria into the pleural space, leading to empyema or pneumonia. 4. Subcutaneous Emphysema: Air leakage into the tissues around the chest tube insertion site. 5. Malposition or Blockage: Improper placement of the tube or obstruction of the drainage system, leading to inadequate drainage.