Chest Drain Management

Intercostal drain monitoring, output charting, and removal criteria

NEVER clamp a bubbling chest drain. NEVER lift the drain bottle above the patient. Call doctor IMMEDIATELY if sudden increase in output, no swinging, or subcutaneous emphysema.

Active Chest Drains

Arjun Reddy, 62M — Thoracics Ward — T1

Right pleural effusion — parapneumonic, 900 mL aspirated

Draining Well
Drain Type: 28Fr intercostal drain — underwater seal
Inserted: 20 Jun 2026 (Day 4)
24h Output: 120 mL (serous)
Total Output: 1,840 mL since insertion
Suction: None — underwater seal only
CXR: CXR 22 Jun — lung fully expanded, drain tip in right base
Continue drain. Remove when output < 50 mL/24h for 2 consecutive days. No suction. Encourage deep breathing.

Rajan Mehta, 75M — ICU-1

Post-CABG pericardial and pleural drain

Draining Well
Drain Type: 28Fr mediastinal + 28Fr left pleural
Inserted: 18 Jun 2026 (Day 6)
24h Output: Mediastinal: 8 mL | Pleural: 22 mL
Total Output: Mediastinal: 480 mL | Pleural: 620 mL
Suction: Low suction -10 cmH₂O
CXR: CXR 22 Jun — satisfactory. No pneumothorax.
Consider drain removal tomorrow if output remains < 100 mL combined. Surgical review.

Document Drain Observation