AB110. SOH23ABS_004. Are chest X-rays being reviewed at an appropriate time following chest drain removal?—a single Irish centre experience and literature review

Background: Insertion of chest drains is a commonly performed procedure for pneumothorax, haemothorax, pleural effusion and empyema. Daily chest X-rays (CXR) to confirm position, interval change and decide on removal are advised. Post-removal CXR should be performed and reviewed in a timely manner to ensure early detection of complications or recurrence. Current care bundles cover documentation for insertion and management of drain but do not specifically include removal. Our aims are to assess time interval between a CXR post chest drain removal being filmed and being reviewed at our institution and assess quality of documentation of chest drain care.

Methods: This is a retrospective study of chest drains, between March 2020 and December 2021. All patients with surgical chest drains were included. Patients with pigtail catheter drains were excluded.

Results: N=91 drains (2 bilateral pneumothoraces). Duration of drains: 4.2 days (1–24 days). Average time for CXR to happen: 208 min ( 11–1,314 min). Average time to review CXRs: 108 min (1–1,077 min). Not reviewed >2 weeks: 4. Twenty randomly selected charts—documentation reviewed.

Conclusions: CXR are essential in assessing resolution of underlying condition. Post-removal X-rays must be reviewed by a clinician in a timely manner to detect complications early. We recommend utilization of the chest drain form which includes post removal management as part of chest drain care bundle.

Keywords: Chest trauma; chest drains; general surgery; trauma; pneumothorax; haemothorax; pleural effusion; chest X-rays (CXR)