Chest Tube Drainage Flashcards
Closed Pneumothorax AKA
Spontaneous Pneumo
Blunt Trauma Closed Pneumo Example:
Broken Rib
Tension Pneumothorax:
Will see trachial deviation due to so much pressure coming from other side. WILL AFFECT THE HEART
Open Pneumo Example:
actual wound
Pleural Effusion:
fluid, hemothorax, chylothorax Will need thorocentesis
Pneumo Treatment:
Complete bed rest
Limited activity
Maybe supplemental 02
Pneumo Treatment > or = 20%
Thoracentesis
Chest Tube Placement
Chest Tube Locations: Removal of Air
2nd - 4th intercostal space in high lateral chest
Chest Tube Locations: Removal of Fluid
5th - 7th intercostal space in low lateral chest or low posterior chest
Chest Tube Locations: Removal of Blood
Low, under the sternum, anteriorly
Drainage Systems:
Three bottle system
Pleur-Evac (three chambers)
Waterless Drainage System
All Drainage Systems Contain:
Drainage Chamber
Water-Seal Chamber
Suction Chamber
Bubbling in red chamber means…
air leak
Infants, young children Chest Tube size:
8-12 FR
Children, Young Adults Chest Tube Size:
16-20 FR
Most Popular Adult Chest Tube Size:
28-32 FR
Large Adult Chest Tube Size:
26-40 FR
Occlusive Dressing changed…
q8 or policy
Daily Assessment of Drainage System:
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
Removal Step:
May clamp for several to 24 hrs
What to do if you think it might have come out:
Chest x-ray
Transport Steps:
Maintain Upright
Below the Heart
Order to remove suction
Changing System:
- Prepare New System
- Clamp CT ABOVE Connection
- Remove Old, Attach New
- Unclamp ASAP
Reasons to clamp CT
Changing
Assessing for Air Leak
Assessing tolerance for Removal
NEVER use _____ to clamp CT!!!
Hemastat with Teeth!
CT is fully pulled out:
Vaseline Immediately Occlusive Dressing Notify MD Stat Prepare for Stat X-Ray Observe for Pneumothorax
