Chest drain care in children

What is a chest drain?

A chest drain is a tube that is inserted between the ribs in the chest cavity in the space between the lung and the chest wall known as the pleural cavity. It does not go into the lungs. A chest drain is inserted to drain air, fluid or pus that has collected in this space.

It is attached to a bottle to drain the space around the lungs. The bottle usually contains water; the end of the drain is submerged into the water. The fluid, air or pus travels down the tube into the bottle .The water acts as a valve, stopping air from re-entering the space where the drain sits.

Who needs a chest drain?

A chest drain is sometimes required if your child has pus (empyema), fluid (pleural effusion) or air (pneumothorax) in the space, making it difficult to breathe normally. The draining of some of this pus, fluid or air from around the lungs can aid recovery and make your child more comfortable.

How long will my child need the chest drain for?

Chest drains are usually removed after two to five days and not normally left in for more than a week. The exact duration will depend on how much fluid or air is drained from the chest tube, and on your child’s condition.

How will it be put in and removed?

The chest drain is inserted either whilst your child is awake using a local anaesthetic to numb the area, if this is felt to be appropriate, or under a general anaesthetic. It can be removed by a nurse or doctor on the wards. The nurse will talk you and your child through the procedure. Your child will normally need an x-ray after the chest drain has been inserted and another x-ray following its removal.

Special care

• Your child can eat and drink normally whilst the drain is in.
• It may be uncomfortable; nursing staff can give pain relief to resolve any discomfort your child may experience.
• Please be aware that the tubes are easily dislodged if pulled or tugged. This can occur accidentally, so please be mindful as your child plays, gets in and out of bed, and so on. Ask nursing staff for assistance as necessary and if you are worried that the drain may have accidentally been tugged or pulled, report it immediately.
• Your child will normally be encouraged to mobilise around the ward as an important part of their treatment, but you will not be able to leave the ward unless accompanied by a member of staff while the drain remains in place. You should be aware that the drain should never be raised above the level of your child’s chest.
• Try to avoid kinking the tubing, swinging the bottle or carrying the drain by the tubing.
• The bottle should remain upright at all times; inform a member of nursing staff if it is knocked over.
• The bottle should always be kept below the level of the chest.

Suction

Your child’s drain may be attached to some low suction equipment to encourage the drainage of fluid. This means that your child will not be able to move far from their bed space.

Are there any long-term complications?

There are not usually any long-term complications. There may be a small scar left where the drain was inserted, but we expect this to fade over time. Your child will be followed-up in the outpatient clinic.