Chest Tube Drainage in Emergency Department: Strategies for Non-Traumatic Pleural Effusion

Chest tube drainage is common in emergency medicine practice. Excluding the thoracic trauma, chest tube drainage in emergency department concerns primary or secondary spontaneous pneumothorax and complicated parapneumonic effusion. Technique must be known by emergency physicians taking care of these patients. Equipment used for drainage or ``drainage pleural catheter'' as proposed by Baumann includes all equipment of thoracentesis left in place at the end of the procedure. Multiplicity of material is available, and the choice of equipment depends on the indication. Chest drain with mandrel is used in case of pleural effusion. Other less invasive equipment are preferred in case of pneumothorax. Complications are different according to the type of drain. Recommendations purposed drains of small calibers in all cases and promoted less invasive strategy, notably in case of pneumothorax. Modality of transport of patients with chest drain is important for the management of patients with chest drain. Ambulatory management is an interesting option in emergency medicine for spontaneous pneumothorax with an ambulatory device attached to a chest drain or for recurrent pleural effusion with tunnelized drain.