Tube Thoracostomy for Trauma

Mauricio (Tony) A Escobar, MD, Michael G. Caty, MD, MMM, Steven R Lopushinsky, MD, MSc

Surgical Decision Making

The majority (76%) of chest injuries resulting in pneumothorax or hemothorax require only a tube thoracostomy for successful treatment [1][2][3].

One of the most common errors in the management of a significant hemothorax is placing a chest tube that is not large enough to adequately evacuate blood.

Chest tube sizes by patient weight [1]

Age

Weight

Chest tube size

newborn to 1 year

3-5 kg

10-12 Fr

1 to 2 years

6-9 kg

12-16 Fr

2 to 4 years

10-11 kg

16-20 Fr

12-14 kg

20-22 Fr

5 to 7 years

15-18 kg

22-24 Fr

19-22 kg

24-28 Fr

8 to 11 years

23-30 kg

28-32 Fr

greater than 11 years

> 30 kg

32-42 Fr

Training models have been developed and successfully implemented to teach pediatric chest tube insertion to pediatric and pediatric emergency department residents [4].

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Last updated: February 9, 2019