Aims and Objectives Chest drains are commonly inserted in the Emergency Department (ED) with a complication rate of 30-40%. Training in chest drain insertion is essential in Emergency Medicine (EM) as approximately 25,000 patients undergo in England and Wales undergo this procedure annually.

There is little research in the Irish setting, specifically regarding the outcomes of patients who receive chest drains in Irish EDs.

This study aims to explore the process of the EM inserted chest drain, elicit the initial complications in the ED and any delayed onset complications at least one week post chest drain insertion.

Method and Design This prospective, multicentre observational study examine the current practice of chest drain insertion in the Irish EDs. This study was conducted by the Irish Trainee Research Network (ITERN) from May 2022 until February 2023. A data collection form was developed based on previous literature and expert consensus opinion of specialists in Cardiothoracic Surgery and EM.

Data was collected during drain insertion and at 1 week post procedure to assess for delayed complications.

Results and Conclusion Data was obtained from 10 sites resulting in 133 drain insertions for 107 patients. The median age was 48 years (IQR 32,69, Range 15-90) and 74.8% (n=80) of patients were male.

On average, 1 drain was inserted per patient (IQR 1,1, Range 1-3).

The indications for drain insertion was spontaneous pneumothorax (n=60), traumatic causes (n=44), pleural effusion (n=2) and iatrogenic pneumothorax (n=1).

The overall rate of successful first attempt at drain insertion was 82.2%.

The immediate complication rate was 32%, the delayed complication rate was 41%. No association was found between drain type, indication or operator and first past success.

This study highlights current practice of chest drain insertion across Ireland. The complication rate of 32% is comparable to international literature. This study shows areas for practice improvement and training to improve patient outcomes.