Pigtailed drain

From WardWiki - Foundation Doctor Helper

A pigtailed drain is a straight, usually plastic, drain that has a cord inside. Without tension the drain remains straight but the end coils when the cord is is tightened. This allows the drain to essentially lock into position, making it invaluable where drainage may take some time and the risk of it falling out is high.

These drains are useful for draining abscess cavities where a large volume can be drained through a small skin puncture.

Management

Foundation doctor management is usually restricted to being aware of such drains and when to take them out. This should be done alone only after removing one with a senior successfully.

Removal of a pigtailed drain

• Check it is to be removed either but written instruction or DIRECT instruction from a consultant. Many drains apparently need taking out only to find that removal was only being considered at the time!

• Contact immediate senior to say the drain is being removed. This helps confirm the action taken and also readies the senior for any problems that may occur.

• Sit or lie patient comfortably on their bed. Never removed drains from a sitting or standing position as vasovagal attack may occur.

• Have a dressing pack ready on a trolley and a yellow clinical bag for waste.

• Clean the area and have a dressing ready to apply.

• The key to safe removal is removing the tension in the cord. This cord is VERY strong and the drain will likely be avulsed from the patient while coiled. This is extremely painful and may be harmful; it is certainly unnecessary.

• The cord must be cut with a stitch cutter or small scalpel; then the drain is slowly but firmly removed.

• If stuck or painful to pull then DON'T pull harder. Instead ask for a senior and explain the situation.