Subsequent management

• Drains should not be clamped prior to removal, or transport of patient.

• Drains may be removed when the lung has re-expanded and there is no air leak (no respiratory swing in fluid level or air leak on coughing).

• Unless long term ventilation is necessary, a drain inserted for a pneumothorax should usually be left in situ during IPPV.

• Remove drain at end-expiration. Cover hole with thick gauze and Elastoplast; a purse-string suture is not usually necessary. Repeat CXR if indicated by deteriorating clinical signs or blood gas analysis.

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