Chest Intubation Checklist

A. Before the procedure

1. Has written informed consent been taken?
2. Has patient been counseled in detail about the procedure?
3. Does the procedure need to be done on urgent basis?
4. Is relevant imaging (chest radiograph, CT chest) at hand and whether further imaging is
required?
5. Is chest drain bottle prepared and suitable drain selected?
6. Site of abnormality clinically confirmed?
7. Correlate clinical signs with imaging?
8. Patient’s drug list and coagulation profile checked?
9. Site of drain insertion localized?

B. Procedure
1. Wear sterile gown, gloves and face mask?
2. Patient properly positioned?
3. Cover area with sterile fenestrated drape?
4. Area scrubbed with pyodine?
5. Is air or fluid confirmed on aspiration?
6. Is appropriate anesthesia given and the tube inserted properly and secured with sutures?
7. Is the tube attached it to drainage system using a connector?
8. Is the site properly covered with sterile gauze and is taped properly?
9. Date, time, and initials on the dressing are written?

C. Post procedure
1. Sutures, tubing and connections are secure?
2. Patient educated regarding precautions about the chest tube?
3. Adequate analgesia prescribed?
4. In case of pleural effusion, no more than 500 ml in first hour or 1500 ml in 24 hours should be
drained?
5. Chest drain chart started?
6. Post-procedure chest radiograph ordered?
7. Is the clamp available near the patient for emergency situations?
8. Maintain chest tube and drainage system patency by:
a. Making sure the drainage tubing is free of kinks
b. Inspecting the air vent in the drainage system to make sure it is patent
c. Making sure the drainage system is located below the insertion site