ICC and UWSD

Question 1

perform an assessment of UWSD

Answer 1

• Swing: Measure number of cm swing, normal swing 3-5cm off suction, greater swing =air leak, when suction is applied swing is reduced
• Drain: amount/volume and colour of fluid drained
• Bubble: Bubbles through the underwater seal = air leak, more bubbles = more leak, should increase on coughing FET/expiring on deep

Question 2

what are the indications for an UWSD

where are they located?

Answer 2

What are the indications for an UWSD?
* collection of air (>20% pneumothorax) blood, pus (fluid) in the pleural cavity.
Where are chest drains usally located?
- to drain air: 2md-3rd intercostal space in the MCL, 3-5TH Intercostal space in the MAL, positioned anteriorly
- to drain fluid: 6th-8th Intercostal space in the MAL, positioned potserobasally
o post surgery, there is air and fluid- therefore two drains apically and basally
o Cardiac Surgery- drains inserted under the sternum in the pericardium and/or mediastinum (no swing/bubbles if in mediastinum) and/or pleural cavity.
Indications before removing an ICC? What is the process?
- drainage of fluid has ceased, or less than 100ml in last 24 hours.
- breath sounds present
- patients lung has reinflated (x ray)
the request for removal must be written in the patients health record