Introduction

A pneumothorax can occur unexpectedly, either spontaneously or due to trauma. When air leaks into the pleural space between the lungs and chest wall, the lung collapses. This significantly impairs the patient’s ability to breathe. However, a tension pneumothorax, where pressure builds to dangerous levels, is even more life-threatening. Therefore, immediate action is required in such cases.

Maritime Medics are trained to handle these emergencies effectively. The insertion of a chest drainage tube is a critical procedure that relieves pressure, allowing the lung to re-expand. At the School of Maritime Medics, trainees receive comprehensive training in this life-saving technique. Not only do they learn how to insert the tube safely, but they also learn how to manage the drainage system throughout the treatment process.

Understanding Pneumothorax and Its Dangers

A pneumothorax, or collapsed lung, can occur in two main ways:

• Spontaneous pneumothorax: This can happen without injury, often affecting tall, thin individuals or those with underlying lung conditions.
• Traumatic pneumothorax: This results from injury to the chest wall or lungs, such as in accidents or blunt force trauma.

In particular, a tension pneumothorax is dangerous because the trapped air prevents the lung from expanding. Moreover, the pressure compresses the heart and vital organs, quickly leading to death if not treated immediately.

The Role of the Chest Drainage Tube

A chest drainage tube is one of the most effective treatments for pneumothorax, especially in emergencies. By inserting the tube into the pleural space, medics can release trapped air, relieving pressure and allowing the lung to re-expand. In maritime settings, where immediate access to hospitals is limited, this procedure becomes even more crucial.

• Tube insertion: Medics insert the tube through the chest wall into the pleural space.
• Drainage system: Once in place, they connect the tube to a drainage system, which continuously removes air or fluid, preventing further lung collapse.

Training in the Safe “Open” Technique

Our training program emphasizes the open technique for chest tube insertion, which ensures safe and accurate placement. This method allows medics to directly visualize the pleural space, minimizing the risk of complications.

1. Insertion of the Chest Drainage Tube

Trainees make an incision between the ribs and carefully insert the drainage tube. Special attention is given to:

• Identifying correct anatomical landmarks to avoid injury.
• Using the open technique for safe access to the pleural space.
• Ensuring the tube is placed correctly for effective drainage.

2. Connection to the Drainage System

Properly connecting the chest tube to a drainage system is essential for continuous air or fluid evacuation. Trainees practice:

• Connecting the chest tube securely to the drainage system.
• Monitoring the system to ensure proper function and detect complications.
• Reading the system’s indicators to assess whether air or fluid is being evacuated effectively.

3. Securing the Tube

Securing the chest tube is critical to prevent dislodgement and infection. Our medics learn:

• How to suture and secure the tube to avoid accidental removal.
• Maintaining sterility around the insertion site to minimize infection risk.

Monitoring and Maintenance

After insertion, the medic continuously monitors the system and the patient’s condition to ensure the chest tube functions correctly. Trainees learn to:

• Check the drainage system output to monitor lung re-expansion.
• Identify signs that indicate the tube is functioning properly.
• Recognize potential complications such as blockages

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Chest drainage tube