ABSTRACT
It is important to note that when diaphragmatic hernias are suspected, tube thoracostomy placement should be avoided, if possible, until CT evaluation has been completed. In certain instances, however, a thoracostomy tube will be deemed necessary due to respiratory distress. In these situations, the thoracostomy tube should be placed above the level of the nipple by an experienced provider, and only after careful digital exploration of the chest cavity under sterile technique. Trocar techniques of thoracostomy insertion should be universally avoided.
