Do junior doctors know where to insert chest drains safely?

Abstract

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