My understanding of the guidance is that U/S is recommended for
effusions - because of the problem of identifying where is the diaphragm
(and liver!)
Interestingly we had a SUI from out of hours where a seldinger drain was
sited by a junior into the lung when apparently draining an effusion
without U/S
Our Trust now runs Chest Drainage training sessions (seldinger) for all
new junior doc starters - which may address some concerns in the future
Mark P
-----Original Message-----
From: Accident and Emergency Academic List
[mailto:[log in to unmask]] On Behalf Of McCormick Simon Dr,
Consultant, A&E
Sent: 08 September 2010 12:22
To: [log in to unmask]
Subject: Chest Drains and Ultrasound
Following the NPSA alert about chest drains and the number of incidents
surrounding their use, are departments using USS routinely to place
their chest tubes?
The major problems for which USS would help seem to revolve around
drainage of fluid rather than air where the white out on a CXR prevents
you from knowing what the anatomy is inside the chest.
The CXR in a simple pneumothorax lets you know where you are going and
provided you stick to the 'triangle of safety' does ultrasound have a
lot to offer. Are people using ultrasound routinely for placing tubes in
simple pneumothoracies?
Simon
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