Anterior placement of a chest tube is appropriate for draining which of the following?

• A. Blood
• B. Fluid
• C. Mixed air and fluid
• D. Air

Answer: (D)

Air rises to the highest point in the pleural space, especially when the patient is upright, so an anterior (apical) chest tube best reaches and evacuates trapped air to rapidly relieve a pneumothorax and re-expand the lung. Fluid, in contrast, tends to collect in the dependent, basilar/posterior areas, so an anterior approach would drain little fluid. Thus, anterior placement is most appropriate for draining air, not fluid or blood.