A patient complaints of breathlessness following a trauma, Trachea shifted to opposite side, Resonant percussion note seen with absent Breath sounds. On inseion of ICD- False statement is
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
Direction of inseion is posterior and superior
Inseion area must be palpated digitally to confirm the position
Inseed into the 4th or 5th ICS along the scapular line
Done in Upper pa of Lower Rib to avoid vessel and nerve injury
Vascular surgery