Practical Pleural Procedure Training by Kung Medics

Develop the ultrasound, anatomical and procedural skills required to perform ultrasound-guided chest drain insertion safely and systematically.

The Ultrasound-Guided Chest Drain Insertion Course by Kung Medics is a focused, hands-on training programme for doctors and healthcare professionals who want to improve their confidence in pleural assessment, site selection and chest drain insertion using ultrasound guidance.

The course combines relevant thoracic anatomy, pleural ultrasound, procedural planning, sterile technique and simulation-based chest drain insertion. It is particularly suited to clinicians who understand the theory but want more supervised practical experience before performing the procedure in clinical practice.

Who Is This Course For?

This course is particularly suitable for:

• Emergency Medicine doctors

• Acute Medicine doctors

• Respiratory trainees

• Anaesthetic and Critical Care trainees

• Internal Medicine trainees

• Foundation doctors with appropriate procedural experience

• Surgical trainees

• Advanced clinical practitioners working within an appropriate governance framework

• International Medical Graduates entering UK acute clinical practice

• Doctors preparing for MRCEM or FRCEM examinations

• Clinicians who want more confidence with pleural ultrasound

• Doctors who have observed chest drain insertion but need more structured simulation practice

What You Will Learn

During the course, candidates develop a structured approach to:

• Understanding indications for chest drainage

• Recognising contraindications and precautions

• Assessing the patient before the procedure

• Understanding relevant chest wall and pleural anatomy

• Using ultrasound to identify pleural fluid

• Selecting a safe insertion site

• Recognising diaphragm, lung and abdominal structures

• Understanding the triangle of safety

• Preparing equipment correctly

• Maintaining aseptic technique

• Administering local anaesthesia safely

• Performing guidewire-assisted chest drain insertion

• Securing and connecting the drain

• Recognising complications

• Completing post-procedure monitoring and documentation

Pleural Ultrasound

A major part of the course focuses on using ultrasound before chest drain insertion.

Candidates learn how to:

• Select the appropriate ultrasound probe

• Optimise depth and gain

• Identify the pleural line

• Recognise lung sliding

• Identify pleural fluid

• Estimate the safest accessible fluid pocket

• Identify the diaphragm

• Recognise liver and spleen below the diaphragm

• Identify consolidated or atelectatic lung where relevant

• Avoid inappropriate puncture sites

• Mark or maintain the chosen insertion site appropriately

Ultrasound findings must always be interpreted alongside the clinical picture and other relevant imaging.

The Triangle of Safety

Candidates review the anatomical principles of the triangle of safety and why appropriate site selection matters.

Teaching includes recognition of:

• The anterior border of latissimus dorsi

• The lateral border of pectoralis major

• The horizontal level around the fifth intercostal space

• The apex below the axilla

Candidates also learn why ultrasound assessment may alter the exact site chosen for pleural fluid drainage.

Patient Assessment and Preparation

Before performing the procedure, candidates learn to consider:

• Clinical indication

• Available imaging

• Coagulation status and bleeding risk

• Anticoagulant or antiplatelet medication

• Allergies

• Patient positioning

• Consent

• Monitoring requirements

• Availability of appropriate assistance

• Escalation planning

Equipment Preparation

Candidates work through the equipment required for safe chest drain insertion, including:

• Sterile preparation equipment

• Appropriate PPE

• Ultrasound equipment

• Sterile probe cover and gel

• Local anaesthetic equipment

• Needle and syringe

• Guidewire

• Dilators

• Chest drain

• Connecting tubing

• Underwater seal or appropriate drainage system

• Sutures and securing materials

• Sterile dressing

The importance of checking all equipment before starting the procedure is strongly emphasised.

Local Anaesthesia

Candidates review the principles of safe local anaesthetic use, including:

• Patient-specific dose considerations

• Maximum-dose awareness

• Infiltration of the skin and deeper tissues

• Anaesthetising the periosteal region where appropriate

• Aspiration before injection

• Recognition of local anaesthetic toxicity

• Monitoring the patient throughout the procedure

Drug choice and dose should always follow local policy and individual clinical assessment.

Chest Drain Insertion Technique

Candidates practise a structured guidewire-assisted insertion technique using simulation models.

Training includes:

1. Confirming the indication and site

2. Positioning the patient

3. Performing ultrasound assessment

4. Preparing a sterile field

5. Administering local anaesthetic

6. Introducing the needle safely

7. Confirming entry into the pleural space

8. Passing and controlling the guidewire

9. Making an appropriate skin incision

10. Dilating the tract

11. Advancing the drain

12. Removing the guidewire

13. Connecting the drainage system

14. Securing the drain

15. Applying a sterile dressing

16. Reassessing the patient

Guidewire Safety

Particular emphasis is placed on:

• Maintaining control of the guidewire at all times

• Avoiding excessive guidewire advancement

• Recognising resistance

• Avoiding force during dilatation

• Confirming that the drain advances appropriately

• Checking that the guidewire has been removed at the end of the procedure

Complications

Candidates learn to recognise and reduce the risk of important complications, including:

• Bleeding

• Haemothorax

• Organ injury

• Diaphragmatic injury

• Lung injury

• Infection

• Malposition

• Drain blockage

• Drain dislodgement

• Subcutaneous emphysema

• Re-expansion pulmonary oedema

• Failure to drain the intended collection

The course emphasises early recognition and appropriate escalation if complications occur.

Post-Procedure Management

Candidates learn the importance of:

• Reassessing the patient

• Monitoring observations

• Checking drain function

• Documenting drain output

• Ensuring the drainage system is positioned correctly

• Reviewing appropriate post-procedure imaging where indicated

• Recording the procedure clearly

• Monitoring for bleeding, pain, respiratory deterioration or drain displacement

• Following local protocols for ongoing drain care and removal

Hands-On Simulation Training

This is a highly practical course.

Candidates have opportunities to:

• Use ultrasound machines

• Identify pleural fluid on simulation or training models

• Practise site selection

• Prepare a sterile field

• Practise local anaesthetic technique

• Insert guidewires

• Use dilators

• Insert simulated chest drains

• Secure and connect drains

• Repeat the full procedure

• Receive immediate instructor feedback

• Correct common technical errors

The aim is to allow candidates to develop a safe, reproducible technique in simulation before progressing to supervised clinical procedures.

Preparing for Clinical Competency

Completion of the course supports procedural development but does not replace formal workplace sign-off.

Candidates should continue their training through:

• Supervised clinical chest drain insertions

• Workplace-based assessments

• Procedure logbooks

• Direct observation

• Pleural ultrasound practice

• Local competency frameworks

• Ongoing review with experienced supervisors

Candidates must follow their employer's local pleural procedure policies and work within their individual scope of competence.

Why Train With Kung Medics?

Candidates benefit from:

• Experienced clinical educators

• Hands-on pleural ultrasound training

• Chest drain simulation models

• Structured step-by-step teaching

• Repeated procedural practice

• Small-group instruction

• Immediate technique correction

• Realistic clinical scenarios

• A supportive environment for clinicians who lack confidence

• Teaching focused on practical UK acute-care settings

Our aim is to help candidates understand not only how to insert a chest drain, but how to select the correct patient, identify a safe site and manage the procedure from preparation through to post-procedure care.

Learning Outcomes

By the end of the course, candidates should have a better understanding of how to:

• Identify appropriate indications for chest drainage

• Recognise important contraindications and precautions

• Use ultrasound to assess pleural fluid

• Identify a safe insertion site

• Recognise relevant thoracic anatomy

• Prepare equipment and maintain aseptic technique

• Apply the principles of safe local anaesthesia

• Demonstrate guidewire-assisted chest drain insertion in simulation

• Recognise common complications

• Complete appropriate post-procedure monitoring and documentation

• Continue toward supervised clinical competency

Important Course Status

The Ultrasound-Guided Chest Drain Insertion Course is an independent practical training programme delivered by Kung Medics.

Completion of this course:

• Does not by itself certify independent procedural competence

• Does not replace supervised clinical training

• Does not constitute employer credentialing

• Does not replace local competency assessment or sign-off

• Does not authorise independent chest drain insertion where local approval is required

Candidates must practise within their competence and comply with local clinical governance, supervision and credentialing requirements.

Book Your Ultrasound-Guided Chest Drain Insertion Course

If you understand the theory of chest drainage but want greater confidence with pleural ultrasound, site selection and guidewire-assisted insertion, this course provides focused practical training in a supportive environment.

Book your Ultrasound-Guided Chest Drain Insertion Course with Kung Medics and develop the procedural foundations needed to progress toward safe, supervised clinical practice.