At what location should a chest tube be placed?

The location for placing a chest tube typically depends on the specific clinical situation, but the best standard practice for the drainage of pleural effusions or the treatment of pneumothorax is to place the chest tube between the 4th and 5th intercostal spaces at the mid-axillary line. This site is chosen because it generally allows for optimal access to the pleural space and minimizes trauma to surrounding structures.

The fourth and fifth intercostal spaces are anatomically safe zones that allow for effective drainage without risking damage to the lung or vital organs. Placing a chest tube at this level reduces the risk of complications and enhances the effectiveness of the procedure.

While the mid-clavicular line also provides a location for chest tube placement, it is often more associated with tube placement for tension pneumothorax and may not provide as optimal a drainage angle as the mid-axillary line. The 8th intercostal space is generally too low and can risk compromising abdominal organs, making it less favorable for standard chest tube procedures.