The number of patients with symptomatic pleural disease who require diagnostic and/or therapeutic intervention is increasing. Many of these patients will present acutely to emergency departments or medical admissions units. As a consequence, pleural procedures such as intercostal chest drain (ICD) insertion must be performed regularly and on both emergent and planned bases for common conditions such as pleural effusion and pneumothorax. Whilst some larger centres have specialist teams who provide a responsive interventional service [1], in the majority of hospitals these pleural procedures are still performed by clinicians of all specialties.