How is a patient positioned for a tube thoracostomy?

Updated: Feb 24, 2020
  • Author: Gil Z Shlamovitz, MD, FACEP; Chief Editor: Nader Kamangar, MD, FACP, FCCP, FCCM  more...
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The patient should be positioned supine or at a 45° angle. Elevating the patient lessens the risk of diaphragm elevation and consequent misplacement of the chest tube into the abdominal space.

The arm on the affected side should be abducted and externally rotated, simulating a position in which the palm of the hand is behind the patient's head.

A soft restraint or silk tape can be used to secure the arm in this location. If a restraint is used, make sure that good blood flow to the hand is present.

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