Chest Tubes

Question 1

Purpose of Chest Tubes

Answer 1

• Re-establish negative pressure in the pleural space
• Pneumothorax (air)
• Hemothorax (blood)
• Pneumohemothorax (air & blood)
• Locations
  
  • Apical (removes air)
  • Basilar - base of lung (removes blood)
  • ex.
    
    • bilateral pneumothorax
      
      • 2 - apical for both
    • unilateral pneumohemothorax
      
      • 2 - apical and basilar on side of pneumothorax

Question 2

Troubleshooting

Answer 2

• In routine, never clamp chest tube
• In emergency, clamp the chest tube
  
  • Never clamp for longer than 15 seconds without Dr. orders
  • Use rubber-tipped double clamps
• If water seal breaks
  
  • First - clamp it, cut tube away from device
  • Best - submerge the tube under water, then unclamp
• If chest tube comes out
  
  • First - cover with a gloved hand
  • Best - cover the hole w/ vaseline gauze, put a dry sterile dressing on top, tape on 3 sides

Question 3

Bubbling in water seal

Answer 3

• if intermittent, it is good
• If continuous, it is bad

Question 4

Bubbling in suction control chamber

Answer 4

• If intermittent, it is bad
• If continuous, it is good