Patient Safety Alert Warns Against Rapid Pleural Effusion Drainage

Pavankumar Kamat

December 07, 2020

The NHS England and NHS Improvement National Patient Safety Team, the British Thoracic Society (BTS) and the Association of Respiratory Nurse Specialists (ARNS) have jointly issued a National Patient Safety Alert on pleural effusion drainage using chest drains.

The safety alert highlights the risk of deterioration as a result of rapid offload of pleural effusion fluid from chest drains.

Conditions such as pleural malignancy may result in large effusions, requiring insertion of a chest drain and controlled drainage of the pleural fluid. However, if large volumes of the fluid are drained too quickly, patients can rapidly deteriorate. Patients could experience a drop in blood pressure and a potentially life-threatening complication called re-expansion pulmonary oedema due to sudden re-expansion of the compressed lung. Therefore, it is essential to control the rate of fluid drainage to prevent cardiovascular instability and collapse.

The alert urges providers to review local chest drain clinical procedures to ensure adherence to BTS and ARNS guidelines and standards, and to ensure that the bedside staff have access to explicit instructions on the frequency of observation, red flag triggers and local escalation procedures for patient deterioration.

This article originally appeared on Univadis, part of the Medscape Professional Network.

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