Blunt Abdominal Trauma

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Mallory B. -

So I recently had a patient transferred in with a ruptured diaphragm and a chest tube that was not in the chest. Patient was showing signs of tension pneumo/hemo. Another chest tube was placed to relieve this tension. My question is, is there any guidance as to where to place these second tubes? Obviously they have to go higher than rib space 4-5 but is there any specific guidelines? I have not been able to find anything in Tintinallis, Rosens or uptodate. Thank you.

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