Intercostal chest drains: a wake-up call from the National Patient Safety Agency rapid response report

Intercostal chest drains have been well established in the management of pneumothorax and pleural effusion, and explicit guidelines exist for the indications for inserting a chest drain. In May 2008 the UK's National Patient Safety Agency issued a rapid response report entitled Risks of chest drain insertion, highlighting significant complications directly related to intercostal chest drain insertions. A systematic search of the National Reporting and Learning System database for chest drain-associated patient safety incidents revealed 12 deaths and 15 cases of serious harm out of a total of 2,152 incidents between January 2005 and March 2008. In response to these alarming incidents the report called for six action points to be implemented by NHS hospitals and the independent sector by 17 November 2008. This review aims to summarise the National Patient Safety Agency recommendations and provide a brief review of the literature on chest drain-related complications.