Kelly (![[info]](http://www.insanejournal.com/img/userinfo.gif){kind=small} thedreammaker) wrote,@ 2009-08-29 16:02:00 |
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Chest tubes!
There are few things we need to know about chest tube collection bottles. They have chambers and each chambers have functions....
1. There is the suction chamber. This chamber should be bubbling all the time when patienit is connected to suction. If on water seal, this does not bubble.
2. Collection chamber. This is where you have you blood collects. We do our O's from this chamber.
3. the famous water-seal chamber. Meaning it is "sealed." Manufacturer's have a specification on how many cc the fluid level is to provide a "SEAL". Should this bubble? If this bubbles, is it bad?
Well, it all depends. If the chest tube was placed to drain blood, liquids ( ex. hemothorax and post cardiothoracic surgical patients)
IT SHOULD NOT BUBBLE. If it bubbles then you have a leak. Is a leak bad? YES.
Now, if the chest tube is used for pnemothorax then the chamber should be bubbling. Should we be concern? NOT AT ALL. It was placed because of pneumo. When bubbling stops therefore pneumo is resolved. Also, in some instances when tubes are pleural chest tubes, there is sometimes small bubbling. Should we be worried. Not really.
I always orient nurses and teach them to always look at the water seal chamber. Always see if you have enough water based on the manufacturer's specification to creat a SEAL. How you do this? Look at the water seal chamber at eye level. If the water is not leveled with the line as provided by the manufacturer then you add water to create the right seal.
2nd. Make sure connections are tight. Most specially the tubes and the rubber connection.
3rd. Asses the dressing and the sites.
4th. Look at the X-rays. One way to find out if your chest tube was dislocated/moved and pulled is to compare the new to the old x-ray. Locate for the holes at the side of the chest tubes( u can easily see this in the x-ray.). These holes should be inside the body of the patients. If its outside then you are in trouble. Obtain and vaseline gauze, applied pressure dressing and call the MD quick. This tube should be removed!
There are few things we need to know about chest tube collection bottles. They have chambers and each chambers have functions....
1. There is the suction chamber. This chamber should be bubbling all the time when patienit is connected to suction. If on water seal, this does not bubble.
2. Collection chamber. This is where you have you blood collects. We do our O's from this chamber.
3. the famous water-seal chamber. Meaning it is "sealed." Manufacturer's have a specification on how many cc the fluid level is to provide a "SEAL". Should this bubble? If this bubbles, is it bad?
Well, it all depends. If the chest tube was placed to drain blood, liquids ( ex. hemothorax and post cardiothoracic surgical patients)
IT SHOULD NOT BUBBLE. If it bubbles then you have a leak. Is a leak bad? YES.
Now, if the chest tube is used for pnemothorax then the chamber should be bubbling. Should we be concern? NOT AT ALL. It was placed because of pneumo. When bubbling stops therefore pneumo is resolved. Also, in some instances when tubes are pleural chest tubes, there is sometimes small bubbling. Should we be worried. Not really.
I always orient nurses and teach them to always look at the water seal chamber. Always see if you have enough water based on the manufacturer's specification to creat a SEAL. How you do this? Look at the water seal chamber at eye level. If the water is not leveled with the line as provided by the manufacturer then you add water to create the right seal.
2nd. Make sure connections are tight. Most specially the tubes and the rubber connection.
3rd. Asses the dressing and the sites.
4th. Look at the X-rays. One way to find out if your chest tube was dislocated/moved and pulled is to compare the new to the old x-ray. Locate for the holes at the side of the chest tubes( u can easily see this in the x-ray.). These holes should be inside the body of the patients. If its outside then you are in trouble. Obtain and vaseline gauze, applied pressure dressing and call the MD quick. This tube should be removed!
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