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Chest drain insertion
Category: Lung & Breathing Tests · All lung & breathing tests
What it is
A chest drain is a tube placed between the ribs into the pleural space to drain air, fluid, blood or pus from around the lung, letting the lung re-expand and stay expanded. It connects to a one-way system (underwater seal bottle or valve).
Why it is done
Indications include a collapsed lung (pneumothorax), pleural infection (empyema), blood after injury, large effusions, and after some chest surgery.
How to prepare
In emergencies this happens immediately; otherwise, ultrasound or CT guides the site. Blood tests and clotting are checked. Local anaesthetic is thorough, with sedation or strong painkillers as needed; tell the team about blood thinners and allergies.
What happens during the procedure
After numbing, a cut is made between the ribs and the tube is guided into the pleural space (small-bore drains are placed over a wire under imaging). It is stitched in place, connected to the drainage system, and a chest X-ray confirms position. Insertion takes about 20 to 40 minutes.
Afterwards — recovery & results
You stay in hospital while the drain is in. Nurses monitor bubbling and drainage; you will be encouraged to move around, with the bottle kept below chest level. Pain relief is given — drains are uncomfortable more than painful. Removal (after the lung is up and drainage stops) takes seconds: the stitch is cut and the tube pulled out smoothly, usually with a breath-hold, then a dressing applied.
Risks & considerations
Risks include bleeding, infection, the tube blocking or falling out, injury to lung or other structures, and air tracking under the skin (surgical emphysema — crackly swelling, usually harmless). Report sudden breathlessness or the tube disconnecting immediately.
Watch: Chest drain insertion videos
Real procedure videos from the MedicalVideos.com library. Some clinical footage is graphic — that is the nature of a medical video library.
Related guides on MedicalVideos.com
Frequently asked questions
Why does the bottle bubble?
Bubbling means air is leaving the pleural space — expected early on with a pneumothorax. It stops as the leak seals; swinging of the fluid level with breathing shows the tube is open and working.
How long will it stay in?
From a day or two for a simple pneumothorax to a week or more for infection or persistent air leaks. Daily X-rays and drainage measurements guide removal.
Related procedures — Lung & Breathing Tests
Browse the C section of the A–Z list or return to the Procedures & Tests hub.