The number of patients with symptomatic pleural disease who require diagnostic and/or therapeutic intervention is increasing. Many of these patients will present acutely to emergency departments or medical admissions units. As a consequence, pleural procedures such as intercostal chest drain (ICD) insertion must be performed regularly and on both emergent and planned bases for common conditions such as pleural effusion and pneumothorax. Whilst some larger centres have specialist teams who provide a responsive interventional service [
], in the majority of hospitals these pleural procedures are still performed by clinicians of all specialties. A recent survey of European internists highlighted the frequency with which pleural interventions are performed by this group of clinicians [
- Bhatnagar R.
- Maskell N.
Developing a ‘pleural team’ to run a reactive pleural service.
Clin Med. 2013; 13: 452-456
]. In the United Kingdom (UK) this need is recognised in the training curricula for core medical trainees (CMT, “senior house officers”) and higher specialty trainees (HST, “specialist registrars”) in internal medicine (IM).
- Cranston M.
- Semple C.
- Duckitt R.
- Vardi M.
- Lindgren S.
- Davidson C.
- Palsson R.
European board of internal medicine competencies working group. The practice of internal medicine in Europe: organisation, clinical conditions and procedures.
Eur J Intern Med. 2013; 24: 627-632
Abbreviations:ICD (intercostal chest drain), UK (United Kingdom), CMT (core medical trainees), HST (higher specialty trainees), IM (internal medicine)
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- Developing a ‘pleural team’ to run a reactive pleural service.Clin Med. 2013; 13: 452-456
- European board of internal medicine competencies working group. The practice of internal medicine in Europe: organisation, clinical conditions and procedures.Eur J Intern Med. 2013; 24: 627-632
- Survey of major complications of intercostal chest drain insertion in the UK.Postgrad Med J. 2010; 86: 68-72
- Pleural procedures and patient safety: a national BTS audit of practice.Thorax. 2015; 70: 189-191
- Survey of core medical trainees in the United Kingdom 2013 — inconsistencies in training experience and competing with service demands.Clin Med. 2014; 14: 149-156
- Intercostal chest drain insertion by general physicians: attitudes, experience and implications for training, service and patient safety.Postgrad Med J. 2015; 91: 244-250
- Do junior doctors know where to insert chest drains safely?.Postgrad Med J. 2005; 81: 456-458
- Chest drain insertion is not a harmless procedure — are we doing it safely?.Interact Cardiovasc Thorac Surg. 2010; 11: 745-748
- Rapid Response Report: Risks of Chest Drain Insertion. NPSA/2008/RRR003.NHS, London2008 ([http://www.nrls.npsa.nhs.uk/EasySiteWeb/getresource.axd?AssetID = 60284&type = full&servicetype = Attachment (accessed 30 Sep 2015)])
- BTS pleural disease guideline group. Pleural procedures and thoracic ultrasound: British thoracic society pleural disease guideline 2010.Thorax. 2010; 65 ([ii]): 61-76
Published online: October 27, 2015
Accepted: October 19, 2015
Received: October 15, 2015
© 2015 European Federation of Internal Medicine. Published by Elsevier Inc. All rights reserved.