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12 Cards in this Set

  • Front
  • Back

Purpose of Chest Tubes

- Removes unwanted materials from pleural cavity allowing the lung to reexpand.

- Must also prevent air from being pulled into chest cavity
Components of a Chest Tube
- Unobstructed chest tube
- Collection chamber
- One way mechanism (water seal)
Chest tubes TYPES
- Pneumothorax – chest tube placed high

- Hemothorax – chest tube place low
Define the One way mechanism
- Simplest way is with water seal

- Done by placing the distal end of the drainage tube in about 2 cm of water

- Air can be forced out but air can not be drawn back into the chest.

- Some newer chest tube system have one way flutter valve
One bottle system
- Rigid straw in container

- Straw is submerged under 2 cm of water

- Exit vent allows pleural
air to escape into the atmosphere.

- Problem:
-- If blood was coming out, then it increases volume in container, causing change in pressure to evacuate fluid in pleural cavity
Two bottle system
- Drainage falls into the collection bottle and air flows into the separate water seal bottle

- Allows more accurate observation of volume and type of drainage

- Can also add suction to help pull out substance in chest

- Supplemental suction is hard to control, though
Three bottle system (The new standard)
- Safest way to regulate the amount of suction
Summary of Procedure to assist in insertion of CT
- Explain procedure to pt-get consent

- Gather equipment

- Set up drainage system-instructions on package

- Position the patient according to physician’s wishes

- Assist physician with insertion (sterile procedure)

- Connect the end of the CT to drainage-tape connections

- Apply dressing

- Connect to suction if ordered

- Adjust tubing so no dependent loops

- document
- RR, vital signs

- Breath sounds

- Changes in LOC/restlessness

- O2 sats

- Subcutaneous emphysema

- Dressing
- Color

- Amount


- Document at least every 8 hours

- Just draw line on bottle when you documented time/date)

- If system needs to be changed, then get new system, clamp chest tube, separate chest tube from system tube, add new system, unclamp tube

- If tube is clamped for a long time, it causes tension pneumothorax, causing the good lung to collapse
CT Procedure Care: Chest tube system assessment
- Tubing free of kinks and dependent loops

- System upright and below insertion site

- Check for fluid fluctuations with breathing

- Check for bubbling (air leak)

- Check for suction-amount, fluid level
What do you do if the chest tube comes out?
Cover the opening and call for help!