Chest Drainage!
1!
Critical Care Monitoring
Chest Drainage
2!
Chest Drainage
Indications
1-
2-
3!
Chest Drainage
Pleural Space
Potential space
Contains fluid lubricant
Can fill with air, blood, plasma, serum,
lymph, pus
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Chest Drainage: Procedures, Indications, Complications, and Care, Study notes of Communication
Comprehensive information on chest drainage, including indications, procedures, complications, and care. Topics covered include pleural space, pleural effusion, pneumothorax, chest tube placement, insertion, and care, as well as associated conditions and signs & symptoms.
What you will learn
- What are the signs and symptoms of chest drainage issues?
- What are the complications of chest drainage?
- What are the methods of chest drainage?
- How is chest drainage care performed?
- What are the indications for chest drainage?
Typology: Study notes
2021/2022
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Critical Care Monitoring
Chest Drainage
Chest Drainage
Indications
Chest Drainage
Pleural Space
Potential space
Contains fluid lubricant
Can fill with air, blood, plasma, serum,
lymph, pus
Chest Drainage
Pleural Space
Compresses underlying lung tissue
atelectasis
↓ intrapleural pressure ↓ ventilation
Infection
Problems when contain abnormal substances:
Chest Drainage
Pleural Space
Detection
Chest Drainage
Methods of Drainage
Thorocentesis -
Thorocostomy (Closed, Tube) -
Chest Drainage
Pneumothorax
May occur after trauma, after surgery,
spontaneously, from underlying lung disease,
after activities (diving, high altitudes, activities
that require stretching chest and rib cage)
Rx -
If leak is major or prolonged
Categorized as spontaneous or traumatic
Chest Drainage
Spontaneous Pneumothorax
Occurs in apparently healthy, young
adult males, ages 20-
Smoking increases risk
May occur in patients with chronic or
acute lung disease
Chest Drainage
Traumatic Pneumothorax
May be a complication of a medical or
therapeutic procedure:
- Subclavian IV, CVP, etc.
- Pleural, transbronchial biopsy
- CMV
- CPR
May be caused by penetrating or blunt
chest trauma
Chest Drainage
Open Pneumothorax
Comes from opening in chest wall
May see mediastinal shift to affected side
(insp)
“Sucking”
Chest Drainage
Non-Tension Pneumothorax
Chest Drainage
Closed Pneumothorax
Communication of air from pleural space to
lung (no air movement with atmosphere)
Can develop into tension pneumothorax
Chest Drainage
Tension Pneumothorax
Mediastinal shift away from affected side
Hyperresonant to percussion
BS ↓ or
absent
↑ RR, HR,
pain
Lethal if not
treated
Chest Drainage
Tension Pneumothorax
Chest Drainage
Tension Pneumothorax
Chest Drainage
Signs & Symptoms
SOB, tachypnea
Sharp chest pain
Dry hacking cough
Cyanosis
Hemoptysis
Tachycardia
Fainting and shock
Decreased or absent BS
Hyper-resonance to percussion
Chest Drainage
Chest Tube Placement
2nd - 3rd intercostal space
Mid-clavicular line
Directed towards lung apex
One tube for pneumothorax
Chest Drainage
Chest Tube Placement
6th - 9th intercostal space
Mid-axillary line
Directed posteriorly
One tube for pleural effusion
Chest Drainage
Chest Tube
Insertion
Chest Drainage
Insertion
Chest Drainage
Radiographs of Chest Tubes
Chest Drainage
Radiographs of Chest Tubes
Chest Drainage
Radiographs of
Chest Tubes
Chest Drainage
Complications
Excessive bleeding
Infection of skin site
Pain
Subcutaneous emphysema
Drainage Systems
Chest Drainage
1 Bottle
Water-Seal
Drainage
Chest Drainage
2 Bottle Water-Seal Drainage
Chest Drainage
3 Bottle Water-Seal Drainage
Chest Drainage
Disposable
Chest Drainage
Care of Patient & System
Apparatus must be lower than patient’s
chest
Avoid kinking or compressing tubing
Keep airtight
Aseptic technique
Chest Drainage
Care of Patient & System
Water-seal bottle
- Tip of tube 2-5 cm below water surface
- Intermittent bubbling from straw if lung has
an air leak
- Spontaneous breathing: expiration
- Mechanical ventilation: inspiration 47 Chest Drainage
Care of Patient & System
Suction control bottle
- Straw at least 10 cm below water level
- Constant bubbling from straw 48 Chest Drainage
No fluctuations in water-seal tube ---
Chest Drainage
No air bubbling in water-seal ---
Good deal !!!
Chest Drainage
No bubbling in Sx control ---
51 Chest Drainage