Here is the OP note:
POST ADMISSION PHYSICAL EVALUATION:
Patient with the dizziness increased shortness of breath and a worsening chest x-ray with accumulation of pleural effusion on the right side question of placement of previous chest tube will reevaluate and change chest tubes.
PREPROCEDURE DIAGNOSES:
Hemothorax/pleural effusion
RATIONALE FOR PROCEDURE:
Accumulation of pleural fluid with shortness of breath and increase hypotension
PROCEDURE IN DETAIL:
Under L control and sterile conditions using aseptic technique and after obtaining informed consent from patient timeout was called and #24 French chest tube was prepped and the previous chest tube was withdrawn without any difficulties. Aiming to go above the rib between the fifth and fourth space blunt dissection with finger as well as with hemostats was done until obtaining good placement. Chest tube was introduced without difficulties obtaining a spontaneous drainage of the dark blood fluid for approximately 500 cc. Chest tube was placed on Pleur-evac with suction and a total of 1000 cc were drained. No bright red blood was observed. No evidence of air leak was found. Patient was kept on Pleur-evac with suction. Chest tube was sutured in place and dressed without difficulties patient tolerated well procedure chest x-ray was reviewed next of kin was notified as well.
POSTPROCEDURE CONDITION:
Patient with O2 saturation above 100% with the 4 L nasal cannula blood pressure heart rate stable patient alert and answering questions appropriately in no distress. Chest x-ray showed chest tube in good place.