Patrick Georgoff, MD

✔️ Make a ~3 cm horizontal skin incision one rib space below. ✔️ Create soft tissue tunnel w/ curved clamp. ✔️With clamp closed, push/pop through intercostal muscles and pleural of rib above skin incision, spread open muscle/pleural ➡️ stay on top of rib to avoid injury to intercostal bundle. ✔️ Finger sweep to confirm you have entered the pleural space & there are no adhesions. ✔️ Use finger + clamp to guide tube insertion (typically, apical + posterior), ensure all drainage holes are in chest. ✔️ Secure, connect to pleurovac, & obtain chest x-ray. Now, watch how to do it: More BehindTheKnife TRAUMA 📹 🧵 2/2