Inseing a Chest Drain Site of Inseion: - Triangle of Safety Boundaries: - * Anterior to mid axillary line * Above level of nipple * Below and Lateral to Pectoralis Major * This usually gets inseed in 5th ICS level. Steps in ICD Inseion: - * Meticulous Sterility maintained. * Inse Local Anaesthesia up to Pleura. * Sharp dissection to Cut only the Skin. * Blunt Dissection using Aery Forceps through the muscles- Intercostal and Serratus anterior. * Oblique tract is made so that the parietal pleura is tunnelled to avoid leakage of air. * Drain in cases of Haemothorax and Pneumothorax should aim the Apex * Drain for Empyema and Pleural effusion should be at Base * Drain should pass at the upper edge of the rib to avoid injury to neurovascular bundle. * Don't apply any clamp in Drain as it may be forgotten to be removed. * Don't apply suction also. * Bubbling drain must never be clamped. * Check the drain location by a Chest X ray. Ref:- Bailey and Love 27th Edition; Pg num:- 920