Chest Tubes

Question 1

The purpose for chest tubes is to ?

Answer 1

The purpose of chest tubes is to re-establish negative pressure in the pleural space

Question 2

pnemothorax (_____ = ____ pressure.. put chest tube in to re-establish ______ pressure!)
hemothorax (______= ______ pressure.. put chest tube in to re-establish _____ pressure!)
pneumohemo (___ &; ___ = ____ pressure.. put chest tube in to re-establish _____
pressure!)

Answer 2

1. In a pneumothorax, the chest tube removes air
2. In a hemothorax, the chest tube removes blood
3. In a pnemohemothorax, the chest tube removes air and blood

Question 3

Location of chest tubes:

Apical is (_____) for ___?
a.
2. Basilar (_____) for ____?
a.

Answer 3

Apicals (HIGH) for Air

a. Label “A”- up high
2. Basi lar (LOW) for Blood
a. Label “B”- placed at base; bottom of lung

Question 4

How many chest tubes (and where) for unilateral pneumohemothorax?

Answer 4

apical and basilar all on same side

Question 5

How many chest tubes (and where) for bilateral pneumothorax?

Answer 5

apical right and left

Question 6

How many chest tubes (and where) for post-op chest surgery?

What’s the exception?

Always assume ?

Answer 6

2; apical and basilar unilateral on the side of surgery

b. Exception: If surgery total pneumonectomy then no chest tube bc no pleural space as lung was removed
c. Always assume chest trauma and surgery is unilateral

Question 7

What do you do if you kick over the collection bottle?

Answer 7

Not a big deal; can just sit it right back up; have take a couple deep
breaths

Question 8

What do you do if the water seal breaks?

Answer 8

a. This is more serious, because it is allowing air in creating a 2 way
b. First: Clamp chest tube (Better no way than 2 way for brief period of
time) **in routine care never clamp chest tube!!
c. Best: Submerge
i. Cut tube away (down) by device; submerge under water
preferably sterile-then unclamp

Question 9

What do you do if the chest tube comes out?

Answer 9

First: cover hole with gloved hand; Vaseline gauze dressing; 3
sided sterile dressing; tape
b. Best: Vaseline gauze

Question 10

Bubbling in chest tube ask yourself two questions?

Answer 10

Ask yourself two questions:

i. WHEN is it bubbling
ii. WHERE is it bubbling

Bubbling in suction tube is expected

Question 11

Rules for clamping the tube:
a.
b.

Answer 11

Rules for clamping the tube:

a. Never clamp for longer than 15 seconds without a Dr.’s order
b. Use rubber t ipped double clamp

Question 12

Positive pressure push the lung away

Answer 12

Positive pressure push the lung away

Question 13

Chest surgery & chest trauma create unilateral ____

Answer 13

pnemohemothorax,

Question 14

If surgery total pneymonectomy( removal of the entire lung) then ! ____ chest tube bc ____ pleural space

Answer 14

If surgery total pneymonectomy then ! no chest tube bc no pleural space