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Letters to the Editor| Volume 28, e13-e15, March 2016

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Safe site selection for chest drain insertion by trainee physicians — Implications for medical training and clinical practice

  • John P. Corcoran
    Correspondence
    Corresponding author at: Oxford Centre for Respiratory Medicine, Churchill Hospital, Oxford OX3 7LE, United Kingdom. Tel.: +44 1865 225205; fax: +44 1865 857109.
    Affiliations
    Oxford Centre for Respiratory Medicine, Oxford University Hospitals NHS Trust, Oxford, United Kingdom

    University of Oxford Respiratory Trials Unit, Churchill Hospital, Oxford, United Kingdom
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  • Robert J. Hallifax
    Affiliations
    University of Oxford Respiratory Trials Unit, Churchill Hospital, Oxford, United Kingdom

    Department of Respiratory Medicine, Buckinghamshire Hospitals NHS Trust, Aylesbury, United Kingdom
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  • Ambika Talwar
    Affiliations
    University of Oxford Respiratory Trials Unit, Churchill Hospital, Oxford, United Kingdom

    Department of Respiratory Medicine, Royal Berkshire NHS Foundation Trust, Reading, United Kingdom
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  • Ioannis Psallidas
    Affiliations
    Oxford Centre for Respiratory Medicine, Oxford University Hospitals NHS Trust, Oxford, United Kingdom

    University of Oxford Respiratory Trials Unit, Churchill Hospital, Oxford, United Kingdom
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  • Najib M. Rahman
    Affiliations
    Oxford Centre for Respiratory Medicine, Oxford University Hospitals NHS Trust, Oxford, United Kingdom

    University of Oxford Respiratory Trials Unit, Churchill Hospital, Oxford, United Kingdom

    NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, United Kingdom
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Published:October 27, 2015DOI:https://doi.org/10.1016/j.ejim.2015.10.014
      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 [
      • Bhatnagar R.
      • Maskell N.
      Developing a ‘pleural team’ to run a reactive pleural 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 [
      • 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.
      ]. 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).

      Abbreviations:

      ICD (intercostal chest drain), UK (United Kingdom), CMT (core medical trainees), HST (higher specialty trainees), IM (internal medicine)

      Keywords

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      References

        • Bhatnagar R.
        • Maskell N.
        Developing a ‘pleural team’ to run a reactive pleural service.
        Clin Med. 2013; 13: 452-456
        • 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
        • Harris A.
        • O'Driscoll B.R.
        • Turkington P.M.
        Survey of major complications of intercostal chest drain insertion in the UK.
        Postgrad Med J. 2010; 86: 68-72
        • Hooper C.E.
        • Welham S.A.
        • Maskell N.A.
        Pleural procedures and patient safety: a national BTS audit of practice.
        Thorax. 2015; 70: 189-191
        • Tasker F.
        • Newbery N.
        • Burr B.
        • Goddard A.F.
        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
        • Corcoran J.P.
        • Hallifax R.J.
        • Talwar A.
        • Psallidas I.
        • Sykes A.
        • Rahman N.M.
        Intercostal chest drain insertion by general physicians: attitudes, experience and implications for training, service and patient safety.
        Postgrad Med J. 2015; 91: 244-250
        • Griffiths J.R.
        • Roberts N.
        Do junior doctors know where to insert chest drains safely?.
        Postgrad Med J. 2005; 81: 456-458
        • Elsayed H.
        • Roberts R.
        • Emadi M.
        • Whittle I.
        • Shackcloth M.
        Chest drain insertion is not a harmless procedure — are we doing it safely?.
        Interact Cardiovasc Thorac Surg. 2010; 11: 745-748
        • Patient Safety Agency National
        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)])
        • Havelock T.
        • Teoh R.
        • Laws D.
        • Gleeson F.
        BTS pleural disease guideline group. Pleural procedures and thoracic ultrasound: British thoracic society pleural disease guideline 2010.
        Thorax. 2010; 65 ([ii]): 61-76