Common complications of chest tube placement are
malpositioning and empyema
; more unusual complications include organ rupture and problems arising after removal, such as recurrent pneumothorax and tension pneumothorax.
What are 5 potential diagnosis for the use of a chest tube?
Indications for chest tube placement include: (a)
pneumothorax
; (b) penetrating chest trauma; (c) severe blunt chest trauma; (d) hemothorax; (e) chylothorax; (f) symptomatic pleural effusion; (g) bronchopleural fistula; (h) chemical pleurodesis for benign and malignant conditions; (i) postoperative use in thoracic/ …
What are the risks to the patient with a chest tube insitu?
Bleeding
: A very small amount of bleeding can occur if a blood vessel is damaged when the chest tube is inserted. Poor tube placement: In some cases, the chest tube can be placed too far inside or not far enough inside the pleural space. The tube may also fall out.
What are some safety considerations when caring for a patient with a chest tube?
- Never lift drain above chest level.
- The unit and all tubing should be below patient’s chest level to facilitate drainage.
- Tubing should have no kinks or obstructions that may inhibit drainage.
- Ensure all connections between chest tubes and drainage unit are tight and secure.
What do you monitor with a chest tube?
- Presence of air leaks.
- Fluctuation of water in water-seal chamber.
- Amount of suction.
- Amount of drainage and type.
- Presence of crepitus (subcutaneous emphysema)
- Breath sounds.
- Patient comfort level or pain level.
How much drainage is normal for chest tube?
This randomized clinical trial was conducted to determine the appropriate volume threshold for removing CT. We hypothesized that the safety of chest tube removal with a daily drainage of 200 ml/day is comparable with more generally accepted level of
150 ml/day
.
What happens when a chest tube is removed?
It can also occur as a complication of certain medical procedures. Chest tubes are often needed
to remove air from around the lung
. Failure to remove such air can be life- threatening if there is a lot of air or a continued leak. Removing the air allows the lung to re-expand and seal the leak.
How long should a chest tube stay in?
The duration for which a chest tube is needed varies but is
usually a few days
. In certain situations, patients can be sent home with a chest tube; however, in most cases they are removed before discharge from the hospital.
How do I know if my chest tube is working?
Start by
examining the air-leak detection chamber in the water seal of the drainage device
. An air leak presents as small air bubbles; the amount of bubbling indicates the degree of the leak. If you notice bubbling, determine location of the leak.
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.
How do you transport a patient with a chest tube?
Ensure that all connections are secure, either using tape or wire banding. Make sure the bandage over the incision is securely taped and occlusive. Mark the
depth of the tube
using a felt-tip marker and continually monitor during transport. If a drainage unit is used, be sure to keep it below the level of the chest.
What is the key to a proper chest tube dressing?
Chest Tube Care basics:
Keep all tubing free of kinks and occlusions
; for instance, check for tubing beneath the patient or pinched between bed rails. Take steps to prevent fluid-filled dependent loops, which can impede drainage. To promote drainage, keep the CDU below the level of the patient’s chest.
Why are chest tubes so painful?
Regardless of the procedure used to place the chest tube, patients often report some discomfort
because the tube lies on the ribs and moves slightly with each breath
. This discomfort is usually temporary. The goal of the procedure is to drain the pleural space.
What is the purpose of suction on a chest tube?
Closed chest drainage systems use gravity and/or suction
to restore negative pressure and remove air, fluid, and/or blood from the pleural space so that the collapsed lung can re-expand
.
How do I know if I have an air leak in my chest tube?
To quantify the amount of air leak in a patient connected to a chest tube, the patient is
asked to cough, and the water column and the water seal column in the chest tube drainage system are observed
. If there are no air bubbles, the pleural cavity is devoid of air.
