Overview

A chest drain is a tube that we put into your chest to let fluid or air leave your body. This is used to help your breathing. 

The drain sits in the space between your lung and your chest wall (the pleural cavity or pleural space). This space is lined by a thin layer (membrane) called the pleura.

You need a chest drain if you have one of the following in your pleural space:

• An air leak (pneumothorax).
• A collection of fluid (pleural effusion).
• A collection of pus (empyema).

These conditions can stop your lungs from working properly and cause problems with your breathing.

You have an injection of local anaesthetic into the skin and the pleura before the procedure. This makes the area numb, so you should not feel any pain.

The chest drain needs to stay in for between a few hours and a few days before we remove it. During this time, you might have chest X-rays to check how well the air or fluid is draining.

It's important to follow the instructions on looking after your chest drain.

Having a chest drain put in

You sit on a chair with your head and arms resting on a pillow on a table, or you lie on a bed with one arm above your head.

An ultrasound scan helps us to find the best place to put the chest drain. You have an injection to numb the area (a local anaesthetic). This might sting slightly for a short time.

When the area is numb, we make a small cut. The doctor gently puts the chest drain tube through this cut. It's common to feel some pressure and tugging as we put in the drain.

The chest drain is held in place with stitches and covered with a dressing.

When the chest drain is in place, we connect it to a bottle that contains water. Fluid or air then travels down the chest drain tube and into the bottle. The water acts as a seal. It stops air or fluid from coming back up the tube into your chest.

We monitor your chest drain regularly.

Sometimes, a lung needs help to expand again after draining. We can connect the drainage bottle to a suction unit on the wall with a long piece of tubing, or to a portable (lightweight) suction unit. The gentle suction (air sucking) effect of the machine helps the lung to expand again.

Pain

Before the procedure, you have an injection of local anaesthetic. This makes the area numb and you should not feel any pain during the procedure.

Your medical team can give you pain medicines to control any pain after the procedure. You can also have regular painkillers if you need them while the drain is in place.

Pain might restrict your movement and breathing. This can increase the time that it takes for your lung to expand. It's important to tell your medical team if you are in pain. They can then keep any pain under control.

Looking after your chest drain

As the fluid or air around the lung drains, you should be able to move more easily. There are a few simple rules that you can follow to lower the risk of any problems.

• You can walk around with a chest drain, but remember to carry the drainage bottle with you.
• Always carry the bottle below the level of your waist. If you lift it above your waist, fluid from the bottle might flow back into the pleural space.
• If the drainage is on a wall suction unit, you will need to stay close to your bed.
• While in bed, keep the drainage bottle on the floor.
• Do not pull on your chest drain or tangle it around your bed.
• Do not leave the ward.

Removing your chest drain

Removing the drain is a simple procedure.

• We remove the dressings and gently pull out the drain.
• The doctor might ask you to breathe in a particular way while the drain is removed.

This procedure can feel a little uncomfortable, but only lasts a few seconds.

If you have any discomfort after we have removed the drain, you can take painkillers (such as paracetamol).

Tell your doctor or nurse if you have any symptoms that get worse (such as lots of pain, difficulty in breathing or a high temperature). 

Risks of a chest drain

In most cases, having a chest drain put in is a routine and safe procedure. Most people find that breathing is much easier when the chest drain is in place. However, like all medical procedures, chest drains can cause some problems.

• Chest drains can sometimes fall out and need to be replaced. The chest drain is stitched in place and always covered with a dressing to help stop this. You can lower the risk of this happening by looking after your chest drain.
• Chest drains can get infected. This happens to about 2 in every 100 people who have a chest drain. Cleaning the skin before the procedure helps to stop this.
• Serious bleeding is rare. About 2 in every 100 people with a chest drain might have significant bleeding during the procedure.

Giving your permission (consent)

We want to involve you in decisions about your care and treatment. If you decide to have a chest drain, we ask you to sign a consent form. This says that you agree to have the treatment and understand what it involves. 

If you would like more information about our consent process, please speak to a member of staff caring for you.