Chest drain training guide
Chest drain insertion is a core emergency and acute medicine procedure, and one where a small error can cause serious harm. Good chest drain training combines anatomy, thoracic ultrasound, a safe insertion technique and safe drainage, practised under supervision until you are competent. This guide explains what UK guidance expects and which skills to practise.
It is general education, not a protocol. Always follow your hospital's pleural procedure policy and the supervision rules of your department.
What UK guidance says about chest drain training
- The British Thoracic Society (BTS) Clinical Statement on Pleural Procedures (Thorax, July 2023) gives practical guidance for adult pleural procedures, including intercostal drain insertion, drain devices and drain bottles. Read it alongside the BTS Guideline on Pleural Disease published with it.
- NHS England issued a National Patient Safety Alert in December 2020 after patients deteriorated when large volumes of pleural effusion fluid were drained from chest drains too quickly. Controlled drainage is part of every safe chest drain.
- Your hospital will set who can insert a drain, how competence is signed off and how many supervised procedures you need.
The skills to practise
- Assessment and consent. Confirm the indication, review imaging, check clotting and anticoagulants, and take informed consent.
- Anatomy. Know the borders of the triangle of safety and why ultrasound may move your site.
- Thoracic ultrasound. Find the fluid, the diaphragm and the organs below it, and mark a safe site.
- Asepsis and local anaesthetic. Set up a sterile field and stay within a safe local anaesthetic dose.
- Seldinger insertion. Control the guidewire at all times and never advance against resistance.
- Drain care. Secure the drain, connect it correctly and control how fast fluid drains.
- Complications. Recognise bleeding, organ injury, re-expansion problems and infection, and know when to call for help.
Why simulation comes first
Practising on a simulation model lets you rehearse each step, make mistakes safely and get feedback before you treat patients. It does not replace supervised practice, but it makes your first supervised procedures safer and calmer.
Our chest drain course in Manchester
The Ultrasound-Guided Chest Drain and Thoracocentesis Course is a half-day, face-to-face course in Manchester with 4 CPD points. You practise pleural ultrasound and Seldinger insertion on simulation models with feedback from our faculty, and you get online pre-course notes and a quiz before the day. A course is not a licence to practise: your hospital signs off competence.
Related courses: ultrasound-guided central venous access, ultrasound-guided lumbar puncture and the Core Emergency Ultrasound (Level 1) course. See all of them on our emergency ultrasound courses in Manchester page.
Frequently asked questions
What does chest drain training cover?
Patient assessment and consent, anatomy and the triangle of safety, thoracic ultrasound, asepsis and local anaesthetic, Seldinger insertion, drain care with controlled drainage, and complications.
Which UK guidance covers chest drain insertion?
The BTS Clinical Statement on Pleural Procedures (Thorax, 2023), the BTS Guideline on Pleural Disease, and the NHS England National Patient Safety Alert on rapid drainage of pleural effusions (December 2020). Follow your hospital policy too.
Why is controlled drainage important?
NHS England issued a safety alert in 2020 after patients deteriorated when large volumes of pleural fluid were drained too quickly.
Does a course make me competent to insert chest drains?
No. A course prepares you, but your hospital signs off competence after supervised practice.
How long is the Kung Medics chest drain course?
It is a half-day, face-to-face course in Manchester with 4 CPD points.