Chest Tube Drainage

Question 1

Closed Pneumothorax AKA

Answer 1

Spontaneous Pneumo

Question 2

Blunt Trauma Closed Pneumo Example:

Answer 2

Broken Rib

Question 3

Tension Pneumothorax:

Answer 3

Will see trachial deviation due to so much pressure coming from other side. WILL AFFECT THE HEART

Question 4

Open Pneumo Example:

Answer 4

actual wound

Question 5

Pleural Effusion:

Answer 5

fluid, hemothorax, chylothorax Will need thorocentesis

Question 6

Pneumo Treatment:

Answer 6

Complete bed rest
Limited activity
Maybe supplemental 02

Question 7

Pneumo Treatment > or = 20%

Answer 7

Thoracentesis

Chest Tube Placement

Question 8

Chest Tube Locations: Removal of Air

Answer 8

2nd - 4th intercostal space in high lateral chest

Question 9

Chest Tube Locations: Removal of Fluid

Answer 9

5th - 7th intercostal space in low lateral chest or low posterior chest

Question 10

Chest Tube Locations: Removal of Blood

Answer 10

Low, under the sternum, anteriorly

Question 11

Drainage Systems:

Answer 11

Three bottle system
Pleur-Evac (three chambers)
Waterless Drainage System

Question 12

All Drainage Systems Contain:

Answer 12

Drainage Chamber
Water-Seal Chamber
Suction Chamber

Question 13

Bubbling in red chamber means…

Answer 13

air leak

Question 14

Infants, young children Chest Tube size:

Answer 14

8-12 FR

Question 15

Children, Young Adults Chest Tube Size:

Answer 15

16-20 FR

Question 16

Most Popular Adult Chest Tube Size:

Answer 16

28-32 FR

Question 17

Large Adult Chest Tube Size:

Answer 17

26-40 FR

Question 18

Occlusive Dressing changed…

Answer 18

q8 or policy

Question 19

Daily Assessment of Drainage System:

Answer 19

S: Site
T: Tube (dependent loops?)
O: Output (I & O doc, >100cc/hr call doc, mediastinal should decrease)
P: Patient (tidaling in water seal chamber -4 to -8 is good

Question 20

Removal Step:

Answer 20

May clamp for several to 24 hrs

Question 21

What to do if you think it might have come out:

Answer 21

Chest x-ray

Question 22

Transport Steps:

Answer 22

Maintain Upright
Below the Heart
Order to remove suction

Question 23

Changing System:

Answer 23

1. Prepare New System
2. Clamp CT ABOVE Connection
3. Remove Old, Attach New
4. Unclamp ASAP

Question 24

Reasons to clamp CT

Answer 24

Changing
Assessing for Air Leak
Assessing tolerance for Removal

Question 25

NEVER use _____ to clamp CT!!!

Answer 25

Hemastat with Teeth!

Question 26

CT is fully pulled out:

Answer 26

Vaseline Immediately
Occlusive Dressing
Notify MD Stat
Prepare for Stat X-Ray
Observe for Pneumothorax