OBJECTIVES Competency in practical skills is an important aspect of training for medical doctors. This questionnaire survey aimed to investigate if the current Foundation Year trainees have performed several practical procedures of importance and their level of confidence in carrying them out unsupervised. DESIGN Questionnaire study. SETTING Five National Health Service hospitals in England...

Chest tubes are commonly used for patients who have undergone a cardiothoracic procedure to avoid the complications related to the accumulation of blood and serous fluid in the chest. Although the traditional methods such as milking, stripping or active chest tube clearance devices are used to establish patency of the chest tubes, they can become clogged at any time after their placement. Our t...

BACKGROUND The optimal chest tube size for the drainage of traumatic hemothoraces and pneumothoraces is unknown. The purpose of this study was to compare the efficacy of small versus large chest tubes for use in thoracic trauma. Our hypothesis was that (1) there would be no difference in clinically relevant outcomes including retained hemothoraces, the need for additional tube insertion, and in...

OBJECTIVES Chest drainage following cardiac surgery is used to avoid complications related to the accumulation of blood and serous fluid in the chest. We aimed to determine the incidence of chest tube clogging and the role of bedside assessment in identifying the potential for failure to drain. METHODS Data from 150 patients undergoing cardiac surgery using cardiopulmonary bypass from March t...

STUDY OBJECTIVES The objective of this study was to determine the impact of the timing of chest tube insertion on outcome for the treatment of empyema, using a new animal model of empyema. DESIGN A prospective, controlled randomized, blinded design was used. SETTING The study was conducted in an animal research laboratory. PATIENTS OR PARTICIPANTS Sixty-six 2- to 3-kg rabbits were used in...

Background In Denmark the placement of chest tubes is routinely performed by the surgical specialties, namely thoracic, orthopaedic and abdominal surgeons. At our emergency department (ED) we have trained emergency physicians in the placement of chest tubes in patients presenting with a pneumothorax. We postulate that patient discomfort associated with dyspnoea from a pneumothorax can be mitiga...

OBJECTIVE Draining of the chest cavity with two chest tubes after pulmonary lobectomy is a common practice. This study aimed to investigate whether using two tubes after a pulmonary lobectomy is more effective than using a single tube. METHOD This prospective randomised study included 100 consecutive patients who underwent lobectomy or bilobectomy for any pathological condition between May 20...

Chest tubes and their accompanying pleural drainage units continue to present challenging questions regarding their optimal use. Appropriate chest tube size selection to accommodate the clinical situation is key, especially in the setting of large pleural air leaks lest a tension pneumothorax ensue. Connection of an appropriate pleural drainage unit to the chest tube is equally important to obv...

PURPOSE Implement a constructivist approach in thoracic drainage training in surgical ex vivo pig models, to compare the acquisition of homogeneous surgical skills between medical students. METHODS Experimental study, prospective, transversal, analytical, controlled, three steps. Selection, training, evaluation. INCLUSION CRITERIA a) students without training in thoracic drainage; b) withou...

Tension pneumothorax in a large man was inadequately drained by needle thoracocentesis with a 4.5 cm cannula. Unsuccessful needle thoracocentesis of a clinical tension pneumothorax in a large patient should be followed immediately by chest drain insertion, without local anaesthetic, as dictated by clinical urgency. If the clinical situation is still not improved other diagnoses should be consid...