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Figure 17.6 Step-by-step guide: Seldinger technique. (a) Sterilising the area
with 2% chlorhexidine in 70% isopropyl alcohol. (b) Infi ltrating
local anaesthetic with blue needle. (c) Infi ltrating local anaesthetic
with green needle. (d) Inserting the trocar needle. (e) Inserting the
Seldinger wire. (f) Dilating over the wire. (g) Inserting the drain.
(h) Connecting the three-way tap (ensuring not open to air). (i) Connecting
the drain to the underwater seal. (j) The drain sutured in position
and dressed.
Blockage of drain: may require fl ush with 10 mL sterile saline.
Complications following intercostal drain
Organ damage: do not insert the sharp trocar into the pleural
Bleeding: stop warfarin before insertion and correct any
Pain (prescribe simple and/or opioid analgesia).
Surgical emphysema may occur with pneumothorax.
Poor position of drain: may need withdrawing slightly.
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