Identify the insertion site, which is usually the fourth or fifth intercostal space in the mid-to-anterior axillary line (just lateral to the nipple in males), immediately behind the lateral edge of the pectoralis major muscle. Instead, with a bit of force directed towards the chest wall, twist your dilator to try and catch some of the fascia, and then pull back as if to try and tear it. This will likely require a few attempts, but you. Adults: Trauma carts should be stocked with 28Fr, 24Fr, 20Fr standard chest tubes and 14Fr pigtail catheter kits. This video is for educational purposes only. Wire Guided Pigtail Catheter Placement copy Step 1: Use lidocaine to make skin wheel and anesthetize underlying SQ tissue and pleura. Tube thoracostomy may be indicated for pleural effusions associated with malignancy, infection, or hemothorax in the post-surgical setting.
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