Intended for healthcare professionals

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Practice Essentials

Managing chest drains on medical wards

BMJ 2018; 363 doi: https://doi.org/10.1136/bmj.k4639 (Published 21 November 2018) Cite this as: BMJ 2018;363:k4639

Rapid Response:

Re: Managing chest drains on medical wards

Well conceived article which highlights the important clinical aspects of chest drain management and also the considerable lack of expertise in acute care hospitals.

The statement in the introduction 'recent British Thoracic Society (BTS) guidelines in the UK necessitate the use of real-time thoracic ultrasonography when inserting a chest drain', should be corrected to avoid confusion. The guideline refers to chest drain insertion for pleural fluid drainage, in which case ultrasonography is strongly recommended. This does not apply to pneumothorax drainage without fluid which can be performed safely at the bedside without specialist equipment.

Competing interests: I inserted lots of chest drains 'blindly' in a past life as a surgical registrar, often on foot of a polite request from a physician.

22 November 2018
Donal B O'Connor
Adjunct Lecturer in Surgery
Trinity College Dublin
Dublin, Ireland