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Consensus Guideline

Pleural Drains in Adults

Prior to removal

  • Check for written orders for drain removal.
  • Check INR is 1.5 or less and when anticoagulants were last given prior to drain removal in patients with anticoagulant therapy.
  • Consider giving analgesia to the patient as soon as the decision for removal is confirmed and documented.
  • Perform a pain assessment prior to removal and offeranalgesia as required.
  • Check that a recent CXR has been viewed to ensure the lung is re inflated.
  • Identify if the small bore intercostal catheter has any self-retaining mechanism which will need unlocking / disabling and confirm the appropriate procedure for removing the intercostal catheter and suture.
  • In the event that releasing the self-retaining locking mechanism does not work, arrange for either patient transfer to radiology for removal or follow the facility endorsed protocol.
  • check the facility or unit preference for the specific phase of breathing required when the tube is being removed.