The hospital would use local anasthetics and proceed with inserting the chest drain. Even with local anasthetics it hurts like hell, but it has to be done in order to fix the problem. And if there is no time for that they would proceeed even without local, the primary concern would be to treat the patient.
It will hurt! ICU nurse here so we see them on a daily basis. Couple layers of muscle to go through, depending on where you need the tube, pleural space aka lung or pericardial space aka heart then they go through the membrane that surrounds the intended organ. These organs normally have small amounts of fluid around them to lubricate the organ while it beats or expands with breathing so they can also not be directly affected by atmospheric pressure.
Had a deflated lung on the left side just last year, i was minutes from being dead when i arrived at the ER. Doc said we have to put in a chest tube NOW. I told them i didn’t want to be put under because I didn’t know if I was allergic to it ( never had surgery before ) They made an incision in between my ribs and put the tube in which involves puncturing the membrane around the lung. They remarked about my pain tolerance being crazy high.
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