Safety Pin as a Chest Tube Clamp – Cause of Iatrogenic Pneumothorax

Excerpt

To the Editor: A 3-y-old girl presented to our emergency with history of fever, cough and respiratory distress for last 7 d. The child was being treated by a private practitioner where a chest X-ray had revealed right sided empyema. The child was started on IV antibiotics and a chest tube was inserted. However the child showed only minimal improvement and was referred to our centre in view of financial constraints. At admission, the child was sick looking, with a respiratory rate of 58/min. The right chest was hyperresonant and air entry was reduced on auscultation. As there was no column movement, we decided to reinsert the chest tube. However it was surprising to note that the chest tube was clamped with a safety pin and the dressing was applied over it (Fig. 1). The safety pin had pierced through the tube causing a leak in the system. On inquiring from the mother, it was elicited that the the chest tube had been placed in a private hospital and she was told that the safety pin will keep the chest tube in place. The child was admitted, started on appropriate antibiotics and the chest tube was reinserted and the safety pin removed after which the pneumothorax resolved.

…