Chest Tubes- Nursing Care, Management and troubleshooting (part3)
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- Опубликовано: 4 окт 2024
- all equipment needed for insertion Assembled and prepared the chest drainage system.
As per recommendation open it in a sterile technique
Using the floor stand to prevent fall of the drainage
With the water provided in the kit Fill water seal chamber with sterile water to the 2 cm line. Which shows zero
Check suction control chamber for correct amount of water level as prescribed.
After insertion of the chest tube, connected the chest tube to the chest drainage system.in a sterile way
The chest tube is then connected to a CDS and all connection points are secured to ensure that the system remains airtight.
Using the floor stand to prevent fall of the drainage or you can hang it with the body of the bed
The water-seal chamber should bubble gently immediately on insertion of the chest tube and during expiration and with coughing.
Continuous bubbling in this chamber indicates a leak within the patient or in the chest-drainage system.
Fluctuations in the water level in the water-seal chamber, rising during inhalation and falling during expiration, should be observed with spontaneous respirations. If the patient is on mechanical ventilation, the pattern of fluctuation is just the opposite.
Applied the prescribed amount of suction.
Regulate wall suction control to create gentle bubbling.
After the tube was sutured in place, assisted the practitioner with applying an occlusive dressing.
Placed split drain sponges around the chest tube, one from the top and one underneath.
Covered them with a gauze dressing. Applied foam or a similar all-direction stretch water-resistant tape over the dressing.
Labeled the dressing per the institution practice.
Taped all the connection points to the drainage system.
Secured the tube to the patient’s skin below the dressing, using a tube securement device or tape.
Ensured that a chest radiograph was obtained.
Some time for the same patient there is 2 chest drains so some models have Dual if you are not goanna use you need to it tight it and clamp securely
Placement
After the procedure, instruct the patient to sit in a semi-Fowler’ s position (unless contraindicated).
Instruct the patient to cough and deep breath, with securing of the affected side. drainage, promoting lung re-expansion, and preventing respiratory complications associated with retained secretions. The application of firm pressure over the chest tube insertion site (i.e., splinting) may decrease pain and discomfort
Encourage active or passive range-of-motion exercises of the arm on the affected side.
Assess for pain at the insertion
site or for chest discomfort
Tachypnea
• Decreased or absent breath sounds
• Hypoxemia
• Tracheal deviation
• Subcutaneous emphysema
• Neck vein distention
• Tachycardia
• Hypotension
• Dysrhythmias
Bloody drainage greater than or equal to 200 mL/hr. Or bright blood more than 100 ml after 1 hour
• Sudden stop of drainage
• Change in character of drainage
Continued pain despite pain interventions
Monitor chest tube output every 1-4 hours and record amount and color
Assess insertion site and surrounding skin
When transporting a patient with a chest tube, the drainage system should be kept below the level of the patient’s thorax to prevent atmospheric air from entering the pleural space.
Monitor fluid levels in the CDS chambers by briefly turning the suction off.
Verify the level of the water in the water-seal chamber is at the manufacturer-recommended level.
Add or remove water as needed per the manufacturer’s instructions using a small needle.
Assess the patient and the system for air leaks.
Change the CDS when it is almost full, or the system’s integrity is disrupted.
To obtain a drainage specimen from a CDS, consult the manufacturer’s instructions for accessing the system.in certain model there is specific sample port
Milking
Do not milk or strip the entire length of tubing. These practices increase intrathoracic pressure, which can entrap lung tissue in chest tube eyelets, resulting in increased bleeding or impairment of left ventricular function.
Do not clamp the tube for an extended period because doing so increases the risk of the patient developing a pneumothorax.
If the chest tube inadvertently becomes dislodged (removed) at the insertion site, place a sterile dressing on the site and tape it on three sides. Do not tape the fourth side to prevent increased tension in the lung. Monitor the patient’s vital signs, oxygenation, and respiratory status, encourage pt to cough and exhale
Chest Tubes Nursing Care Management Assessment for Review Drainage System
chest tube removal
I love how he explained several different scenarios
الله يفرج همك على هذا الشرح الممتاز
الله يسعدك سعاده الدارين
Well done, كثير معلومات قلتها انسألت عنها في الهيئة
الله يعطيك العافية، فيديو جميل ومفيد
Great job dear , you cover most of topics need to understand about chest tubes care
Fantastic. Truly. Thank you so much. I just subscribed. Please keep posting
Fantastic video
You deserved more subscribers, sir :)
Well explained my Mr Fadi
Thank you for a clear explanation
Great explanation
Omg this was so good. Thanks!
Well explained 👏🏿👏🏿👏🏿 thank you!
It was so helpful.Thank you so much.
Helpful!
amazing!
الله يسعدك يارب
Thanks
Means that column A is only of suction. If no suction then then no need to fill with water! Am I right??
Bravo
Awesome
Tku for your explanation
Where did you get your MSN from. I am studying in USA now and almost done with my ADN.
شكرا كثير ياريت لو تعمل فيديوات اكثر
حبيت النسخ العربيه اكثر
KSU
Am sorry when do we milk a tube? or at what stage will it be necessary to milk the tube?
in general not recommended
based on some references I read you can do it if there is obstruction preventing fluid or blood to drain
by the way if we prevent the tube to have dependent loop this blod clotting is preventable
Can't find part 1 and 2 :-(
ruclips.net/video/gVEXZmt8v1M/видео.html
ممكن ترجمة بالعربي او فرنسي من فضلك
ruclips.net/video/0GU7exV5fYU/видео.html
انتوا عرب ليش متشرحون بالعربي ؟! عجيب امركم .. كل الدول تدرس وتشرح بلغتها الا العرب
ruclips.net/video/0GU7exV5fYU/видео.html