CLINICAL AUDIT

Do junior doctors know where to insert chest drains safely?

J R Griffiths, N Roberts

Department of Cardiothoracic Surgery, Northern General Hospital, University Hospitals Sheffield, Sheffield, UK

Correspondence to:
Correspondence to:
Dr J Griffiths
Department of Accident and Emergency, Rotherham General Hospital, Moorgate Road, Rotherham, South Yorkshire S60 2UD, UK; jrgriffiths{at}doctors.org.uk

Background: The safe insertion of a chest drain is a skill doctors across specialties require. Incorrect placement can lead to significant morbidity and even mortality.

Methods: This audit surveyed junior doctors working in a teaching hospital about their specialty and level of experience with intercostal drains. They were then asked to mark on a photograph where they would insert a chest drain for a pneumothorax in a non-emergency situation.

Results: Of the 55 junior doctors surveyed, 45% were outside the safe area of chest drain insertion as defined by the British Thoracic Society. The most common error was a choice of insertion site too low (24%).

Conclusions: In this audit 45% of juniors surveyed would have placed a chest drain outside the safe triangle recommended by the British Thoracic Society. The common mistake of a choice of insertion site too low should be discussed in postgraduate teaching programmes.

Keywords: audit; chest drain; junior doctors

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