Most commonly intercostal drainage is put to evacuate:
Infections ( Tuberculosis / Pneumonias ).
Pneumothorax ( Air in the pleural space ).
Before and after surgery: Thoracoscopy.
After trauma to chest to assess the bleeding internally (Hemothorax).
Excess pleural fluid in selected cases.
It is an indoor admission procedure. The concerned patient will be admitted for the procedure and kept for at least 2-3 days. Typically admission days vary individually and with the diseases for which ICD tube was put. The important points should be discussed with the doctor during visits.
Pain: The ICD is put under local anesthesia and with mild sedation. This makes it minimally painful during the passage of tube in the chest. Once completed the tube stays in the chest till decided on removal and fixed in place using suture / stitches on the chest. There will pain medications prescribed to manage the pain associated and individually tailored. The pain is temporary and stops after removal of the drainage tube. However, if at any time should you feel the pain during the procedure feel free to let the doctor know.
Bleeding: usually minimal bleeding from local site is present and stops in few minutes. In case it does not please make sure you tell doctor immediately. Blood thinning medicines like warfarin and acitrome will be stopped as decided by the doctor.
Fainting: common with anxious patient usually when painful and stressful situations arise and will be managed by the doctors in case it happens after procedure please inform doctor immediately.
On the day of procedure do not stay empty stomach / fasting. This procedure should take approximately 45minutes to 1 hour. Discuss all the medication with the doctor before and after the procedure. The doctor will check the blood investigations including the blood counts, platelets and the INR if not an emergency. The doctor will perform examination prior to performing the procedure and ask for consent in writing before the procedure. In case of trauma and expected bleeding the blood group will be checked or confirmed in event of emergency. After the routine checks, the chest will be cleaned with solutions. With all sterile precautions. (Avoiding even minimal infections from outside), local anesthesia will be given. The drain will then be inserted between the ribs in the anaesthetised area and connected to a tube and drainage bottle containing water. The water acts as a one way seal to prevent air or fluid to drain out and not go back into your chest. We use both a stitch, to tie the drain in, and adhesive dressing on the skin. However, please move carefully as drains can still be pulled out. X-Rays of the chest will be done to check the status of the fluid and position of tube, etc. after the procedure and from time to time.