Chest drains also known as under water sealed drains (UWSD) are
inserted to allow draining of the pleural spaces of air, blood or fluid, allowing expansion of the lungs and restoration of negative pressure in the thoracic cavity
. The underwater seal also prevents backflow of air or fluid into the pleural cavity.
What are the three sections of the chest tube drainage system?
After a chest tube is placed, it’s connected to a drainage system like an Atrium (which I’ll be referencing in this post). This closed system consists of three chambers:
collection, water-seal, and suction control
.
What are the two major reasons to use a chest tube drainage system?
- a collapsed lung.
- a lung infection.
- bleeding around your lung, especially after a trauma (such as a car accident)
- fluid buildup due to another medical condition, such as cancer or pneumonia.
- breathing difficulty due to a buildup of fluid or air.
What is the purpose of chest tube drainage?
A chest tube is a plastic tube that is used
to drain fluid or air from the chest
. Air or fluid (for example blood or pus) that collects in the space between the lungs and chest wall (the pleural space) can cause the lung to collapse.
How do you maintain a chest tube drainage system?
To promote drainage,
keep the CDU below the level of the patient’s chest
. Monitor water levels in the water- seal and suction-control chambers. Water in both chambers evaporates, so be sure to add water periodically to maintain the water-seal and suction levels.
What is a normal amount of chest tube drainage?
Compared to a daily volume drainage of
150 ml
, removal of chest tube when there is 200 ml/day is safe and will even result in a shorter hospital stay.
How much chest tube drainage is normal per hour?
7.1 Place container upright on floor. 7.2 Mark and date drainage, at eye level, on collection chamber. 7.3 Record. Pediatric:
3 mL/Kg/hour in a 3 hour period
or 5 to 10 mL/Kg in any 1 hour period.
How do you know if a chest tube is functioning?
The water in the water
-seal chamber should rise with inhalation and fall with exhalation
(this is called tidaling), which demonstrates that the chest tube is patent. Continuous bubbling may indicate an air leak, and newer systems have a measurement system for leaks — the higher the number, the greater the air leak.
Is Tidaling normal in chest tube?
However, with positive-pressure mechanical ventilation, tidaling fluctuations are the opposite: the water level decreases during inspiration and increases during expiration. If tidaling doesn’t occur, suspect the tubing is kinked or clamped, or a dependent tubing section has become filled with fluid [8], [14].
What are the different types of chest tube drainage systems?
Once a chest tube is in place, a chest drainage system (CDS) is attached. There are basically four types of CDS:
one-way Heimlich valve, analog three-container systems, digital or electronic CDS, and simple vacuum bottles (for IPC drainage)
5.
How long can a chest tube be left in?
Your doctors will discuss with you how long the drain needs to stay in. This may be from
between one day to one to two weeks
, depending on how well you are responding to treatment. You may need to have several chest X-rays during this time to see how much fluid or air remains.
When should a chest tube be removed?
Chest tubes are commonly used to drain fluid following surgery involving the pleural space. Removal can be considered when
there is no empyema or air leak
, and fluid drainage has decreased to an acceptable level.
Is continuous bubbling normal in chest tube?
Air bubbling through the water seal chamber
intermittently is normal
when the patient coughs or exhales, but if there is continuous air bubbling in the chamber, it can indicate a leak that should be evaluated.
What should be at the bedside of a patient with a chest tube?
2.4
A bottle of sterile water must be located
at the bedside to use in case of accidental disconnection of chest tube from drainage unit. 2.5 Two (2) chest tube clamps must be with the client at all times while chest tubes are in place.
What are the indications for under water seal drainage?
- Pneumothorax (spontaneous, tension, iatrogenic, traumatic)
- Pleural collection – Pus ( empyema), blood ( hemothorax), chyle ( chylothorax)
- Malignant effusions (pleurodesis)
- Postoperative.
- Thoracotomy.
- Video-assisted thoracoscopic surgery (VATS)
What causes air leak in chest tube?
If an air leak lasts > 5 to 7 days, it is termed a persistent air leak (PAL). A PAL is commonly caused by a
spontaneous pneumothorax from underlying lung disease (secondary spontaneous pneumothorax)
, pulmonary infections, complications of mechanical ventilation, following chest trauma or after pulmonary surgery.
