Intercostal Catheter Insertion

Intercostal catheters (ICCs) are tubes inserted to drain air or fluid, which may include blood or pus trapped in the pleural space. The presence of air or fluid within the pleural space impairs the lung expansion capacity and compromises the breathing ability of patients. ICCs are inserted using image guidance such as ultrasound or CT scans.

Reasons why there may be fluid or blood in the pleural space include:

• Injury
• Disease 
• Surgical procedure
• Empyema (collection of pus in the pleural space, second to respiratory infection)
• Pneumothorax (air in pleural space)
• Hemothorax (blood in the pleural space)
• Post cardiac surgery
• Symptoms often associated are shortness of breath, decrease in mobility, oedema

Please continue all regular medications with a sip of water unless instructed otherwise.
Please consult your doctor if you are currently taking medications that thin the blood (Aspirin, Plavix, Warfarin etc)  as these may need to be stopped prior to your appointment. It may be useful to bring a LIST of medications to your appointment.

You will need to bring any previous films (x-ray/CT/MRI/US) along to your appointment.

It is important to inform a member of staff as soon as possible if you are pregnant or suspect you are pregnant BEFORE the test is performed. If you suspect you could be pregnant then a pregnancy test will need to be performed prior to the commencement of the examination.

For health and safety reasons, family members cannot be present with you during the procedure. A staff member will be available to assist you at all times during the procedure if you have any concerns.

A doctor will explain the procedure and you will be required to sign a consent form. If you require an interpreter, please inform the booking clerk at the time of booking.

You will be asked to change into a hospital gown.
During the procedure you will be asked to sit up the bed upright and lean forward on a desk to support your weight. This enables the doctor to gain needle access to your chest from behind.

The skin over your back is swabbed with an antiseptic solution and draped with sterile surgical towels. The doctor will use imaging assistance such as ultrasound or CT to determine the best place to put the drain.

Local anaesthetic is injected into the skin to numb the area.

A drain will be inserted to relieve pressure and fluid build up. During this time you may experience a bit of pulling and pushing sensation but should not be painful. The drain will be secured and a dressing applied. Samples may be sent pathology upon request of your doctor.

Once drain is inserted your vital signs will be monitored regularly and drainage output, until adequate amount is removed. The drain will be removed by either the nursing staff or the doctor and a small dressing will be applied to the area.

Staff will discuss with you what level of activity is suitable after your procedure. It is not uncommon to be sore and experience light bruising at the puncture site. Pain is usually well controlled by taking over the counter analgesics.

A chest x-ray may be requested after the procedure to assess the drains positioning and also after the removal of the chest drain to assess for the presence of any residual fluid/air.

A report regarding your procedure will be given to you before you leave to give to your referring doctor. It contains information about your procedure and any findings that your doctor should know about.