FTP1.13 Improving the use of chest drains in trauma - Small but perfectly formed

Abstract Aims The Western Trauma Association (WTA) advocates using small-bore chest drains (e.g. 14Fr) in haemodynamically normal trauma patients for management of small Haemothoraxes (HTX) or Pneumothoraxes (PTX). This quality improvement project aimed to assess implementation this guidance. Method We compared the use and outcomes HTX PTX before (Cohort 1) after 2) adoption WTA recommendations a District General Hospital London. included all admitted under Surgeons with rib fractures. Results All were blunt injuries. Cohort 1: 60 [36 males, mean age 72 years (range 31-96)] from May–December 2021. 2: 77 [42 73 23-102)] 2022. In cohort 1, 10 (16%) required drains, surgically inserted large-bore (median size 28 Fr) there no peri-procedural complications. 2, 11 (14%) drains; 5 placed large bore 6 by Seldinger technique 18Fr). Two had periprocedural complications both re-insertion. was years. group complications, occluded 75 Conclusion After policy, drain increased appeared safe. audit supports recent literature suggesting are as effective larger better tolerated.