Chest Drain

I saw quite a few chest drains on the respiratory ward and also in ITU (intensive care unit) whilst in the hospital so thought I would find out what they do. A chest drain is "a hollow, flexible tube in the chest, acting like a drain" (http://www.nlm.nih.gov/medlineplus/ency/article/002947.htm). They are used to drain fluids from the body such as  "blood, fluid or air from around your lungs, allowing the lungs to fully expand" (http://tinyurl.com/d37r3ur), so it is mainly used when the lungs have been compressed, thus decreasing the size of the lungs and causing reduced efficiency. The chest x-ray below (http://tinyurl.com/cw6cy96) shows a 'pleural effusion' (shadow on the right side of the picture (left lung))-the "buildup of fluid between the layers of tissue that line the lungs and chest cavity" (http://tinyurl.com/3e5hnul) which is the area where the chest drain takes fluid from, in "the space between the inner lining and the outer lining of your lung" (http://tinyurl.com/d37r3ur).

The "body produces pleural fluid in small amounts to lubricate the surfaces of the pleura, the thin tissue that lines the chest cavity,surrounds the lungs. A pleural effusion is an abnormal, excessive collection of this fluid" (http://tinyurl.com/3e5hnul).

It is inserted and guided to the right area by 'numbing the area where the drain will be inserted, it is then inserted through a cut in your skin between your ribs' (http://tinyurl.com/d37r3ur) as can be seen below (http://www.umm.edu/patiented/articles/000618_2.htm).

The tube, once in the right position (as above), then removes the fluid from the lining of the lung using suction. It is then removed once no more fluid comes out of the drain as there is no need for the drain anymore. An x-ray is then carried out again to see the improvement and the lung should look almost normal, with almost all of the fluid removed.

Video of the procedure: http://www.youtube.com/watch?v=fp1uBR8Lvn4.

BRI Work Experience

Haven't posted for a while...sorry about that! So i'm going to make it up to you all and do a few posts in the next few weeks..

A short one for now. Just finished three days of work experience at the BRI (Bristol Royal Infirmary). I had a day on a cardiac ward which dealt with some pre-op patients and other patients with severe heart issues leading to other issues in the body and I witnessed a number of extremely ill patients. I also spent a day in cardiac theatre, observing two open heart operations as in the 'Cardiothoracic Surgery' post, one of which was to replace the mitral valve (left atroventricular valve) of the heart and the other was to remove and replace a section of the Aorta. Both of these were extremely tricky operations but carried out with great skill by the surgeons.

In theatre there is a huge amount of teamwork required for a successful operation. The two surgeons require a surgeons assistant to pre-empt what the surgeon will need in terms of tools, and will then ask for the tools off the nurses who are in the non-sterilised zone. Then there is the anaesthetist and his/her assistant and also someone who is in charge of the cardiopulmonary bypass machine, which takes over heart and lung function in the operation whilst the heart is stopped.

On the third day I spent time on a different ward mainly involved in respiratory illness where I met some fantastic foundation doctors, training doctors and consultants. Talking with them and just observing them was so interesting and gave me such an insight into what to expect in the first few years of being a qualified doctor and beyond that and have acted as role models for me to aspire too in the future.

One news story, found it in The WEEK (9th June 2012 issue 872 page 16), bit of a funny one!
"Doctors in India have operated to remove a live fish from the lung of a 12-year-old boy. Anil Barela accidentally inhaled the 9cm specimen while playing a fish-swallowing game with fiends on the banks of a river!!"