Chest tube
Formal Definition
A flexible tube inserted through the chest wall into the pleural space to drain air (pneumothorax), blood (hemothorax), fluid (large pleural effusion or empyema), or pus; connected to a water-seal drainage system (e.g., Pleur-evac) with or without suction.
How It's Used on the Ward
"Needs a chest tube" or "we placed a chest tube" — both the procedure and the device are referred to simply as "the chest tube."
Example
""Post-intubation CXR showed a large left pneumothorax with tracheal deviation — tension physiology. Needle decompressed immediately with a 14G at the 2nd intercostal space, then placed a 28Fr chest tube in the 4th ICS mid-axillary line. Good air return on placement, lung re-expanded on repeat film.""
Clinical Context
Indications: pneumothorax (large, tension, or in intubated patients), hemothorax, empyema, large symptomatic effusion. Small-bore pigtail catheters (8–14Fr) are increasingly used for simple pneumothorax and free-flowing effusions; large-bore tubes (28–32Fr) for hemothorax or thick fluid. Insertion site: 4th–5th ICS, anterior to mid-axillary line ("triangle of safety"). Water-seal system: air leak visible as bubbling in water-seal chamber; output tracked hourly. Chest tube is not removed until lung re-expanded and output < 100–200 mL/day (varies by indication).