Thoracostomy tube insertion, horse

Insertion of a thoracostomy tube in a horse. A. The tube is grasped firmly with one hand to control depth. The other hand is placed over the trocar base to allow for insertion with blunt dissection, just cranial to the rib to avoid the intercostal vessels and nerve. B. After penetration of the pleura, the tube is advanced off the trocar, aiming cranial and ventral. Once centered within the effusion, the tube is secured with a purse-string and finger-trap suture pattern. A one-way valve is attached to prevent the inadvertent entry of air.