Chest Tube Management Chest Tubes Use of tubes

Chest Tube Management

Chest Tubes Use of tube(s) +/- suction to return negative pressure to intrapleural space thereby reexpanding lung(s) Air, blood, fluid, or pus can disrupt negative pressure Pneumothorax – CT placed at 2 -3 ICS Tension pneumothorax Hemothorax – CT placed at 8 -9 ICS Pleural effusion Empyema

Chest Tube Placement Assisting Assessment Surgical consent Pain medication Patient education Treatment of anxiety Prepare set-up Connect chest tube to system Tape all connections

Components of Chest Tube System Water seal Chamber for drainage with method for marking output Suction source to water seal chamber Same chamber connects to a suction control chamber with air vent

Chest Tubes – Nursing Management Frequent client assessment – respiratory system, pain, positioning Insertion site – drainage, SQ emphysema Ensure tubing not kinked or clamped Maintain drainage collection system below level of insertion, water levels Observe for tidaling Monitor drainage Encourage movement, cough, deep breathe Q 2 hours

Chest Tubes Complications Excessive drainage Sudden cessation of drainage Air leak Problems with unit Tipping over System breakage Tube is pulled out