Chest Tube Thoracotomy

Question 1

What is the MAIN PURPOSE of CTT?

Answer 1

For LUNG REEXPANSION

Question 2

Differentiate your THORACENTESIS and CTT?

Answer 2

Thoracentesis is temporary and fast to do while CTT is for chronic use and allows continuous drainage.

Question 3

How mant days after CTT is lung reexpansion achieved?

Answer 3

Within 3-5 DAYS

Question 4

What are the TYPES of BOTTLE SYTEM?

Answer 4

One-way, Two-way, and Three-way

Question 5

What does a ONE-WAY BOTTLE SYSTEM collect?

Answer 5

Fluid, Blood, and Pus

Question 6

What does a TWO-WAY BOTTLE SYSTEM collect?

Answer 6

MORE FLUID, BLOOD, and PUS

Question 7

Which is the MOST POPULAR and MOST COMMONLY USED bottle system?

Answer 7

Three-way bottle system

Question 8

What are the uses of each bottle in the THREE-WAY BOTTLE SYSTEM?

Answer 8

First bottle is for DRAINAGE, second bottle is for the WATER SEAL, and the third bottle acts as a SUCTION

Question 9

What does the THREE-WAY BOTTLE SYSTEM collect?

Answer 9

FLUID, BLOOD, PUS, and AIR

Question 10

The DRAINAGE/COLLECTION BOTTLE should not exceed how many ML/HR and ML/24HR?

Answer 10

Drainage should not exceed 100 ML/HR and 500 ML/24HR

Question 11

How deep should the WATER SEAL (2nd bottle) be soaked in water?

Answer 11

More than 2 CM

Question 12

What is the NORMAL ACTIVITY in the WATER SEAL?

Answer 12

INTERMITTENT bubbling, fluctuation, oscillation

Question 13

What does CONTINUOUS BUBBLING in the WATER SEAL indicate?

Answer 13

Air leak

Question 14

What is the patient at RISK FOR when temporary clamping of the CTT is done?

Answer 14

Tension pneumothorax

Question 15

What does it indicate if the bubbling stops AFTER clamping the CTT tube?

Answer 15

The leak is INSIDE THE CHEST

Question 16

What does it indicate if the bubbling is STILL CONTINUOUS after clamping?

Answer 16

The leak is in the TUBE or BOTTLE SYSTEM

Question 17

What do you do if the LEAK is in the BOTTLE SYSTEM?

Answer 17

Clamp TOWARDS the bottle until the leak is located (when the bottle STOPS bubbling) and replace what needs to be replaced

Question 18

What does STOPPED BUBBLING in the WATER SEAL indicate?

Answer 18

Obstruction or lung reexpansion has been achieved

Question 19

How do you CONFIRM LUNG REEXPANSION?

Answer 19

Get an order for an X-RAY

Question 20

What type of PRESSURE is found in the SUCTION CHAMBER?

Answer 20

NEGATIVE pressure

Question 21

What is the NORMAL ACTIVITY found in the SUCTION CHAMBER?

Answer 21

CONTINUOUS, MILD bubbling

Question 22

What does INTERMITTENT BUBBLING in the SUCTION CHAMBER indicate?

Answer 22

INADEQUATE suction pressure

Question 23

What is the NORMAL SUCTION PRESSURE for WALL-MOUNTED equipment? How about for PORTABLE?

Answer 23

Wall-mounted: 80-120 mmhg

Portable: 10-15 mmhg

Question 24

What does STRONG BUBBLING in the SUCTION CHAMBER indicate and what can this cause?

Answer 24

Excess suction pressure which can cause TRAUMA

Question 25

What is the DIFFERENCE between DISLODGE and DISCONNECT?

Answer 25

DISCONNECT is from the BOTTLE while DISLODGE is from the CHEST

Question 26

What to do if the bottle is DISCONNECTED?

Answer 26

Reconnect, kink/clamp temporarily, and SOAK the tubes in the sterile water

Question 27

What should you NOT do if the tube is DISLODGED from the patient’s chest?

Answer 27

DO NOT REINSERT!

Question 28

What should be done if a BLOWING SOUND is heard?

Answer 28

Allow the sound to finish so excess air can come out to prevent TENSION PNEUMOTHORAX

Question 29

What should be done if a SUCKING SOUND is heard?

Answer 29

Cover the hole to prevent an OPEN PNEUMOTHORAX

Question 30

How should the dislodged hole be taped with gauze?

Answer 30

Only tape 3 sides, leave BOTTOM SIDE untaped for ventilation during exhalation