Wednesday , September 19 2018
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ICD Tubing Chest tubing

Assisting For Insertion Of ICD To Child

Purpose

To remove air and fluid from pleural cavity and aspirate plural fluid for diagnostic studies.

Scope

Children who are suffering from infection of pleura.

Definition

Insertion of a needle into the pleural space to remove accumulated fluid and air using aseptic technique.

Applicable Areas

NICU

Responsibility

Staff Nurse, Auxillary Nurse, Head Nurse and RMOs.

Procedure

  • Keep the following equipments ready –
  • Intra Costal Drainage Set.
  • Sterile gloves and mask.
  • Betadine scrub solution and spirit.
  • Sterile cotton swabs and gauze.
  • Sterile Romovac ICD Drain.
  • Sterile normal saline.
  • Two clamps.
  • Trocar appropriate for the size of the child # 8 to # 10 # 12 French for premature infants and upto # 28 French for adolescents.
  • Suture packet with needle.
  • Surgical blade.
  • Adhesive tape.
  • Betadine ointment.
  • Tincture benzoin.
  • Tubes for laboratory analysis for fluid, if needed.
  • Emergency trolley (crash Cart).
  • Disinfectant for Hand Hygiene.
  • Explain the procedure to the parents and obtain written consent.
  • Keep required equipments ready.
  • Wash hands and apply disinfectant before procedure.
  • Assist for Gloving.
  • Assist for skin preparation using strict asepsis.
  • Assist for the procedure.
  • Collect specimen.
  • Observe the child for complications.
  • Check vitals frequently.
  • Inform the physician, if any change occurs in vital signs.
  • Apply Betadine ointment and dressing at site of insertion.
  • Observe for respiratory fluctuations in the water seal chamber to confirm tube patency.
  • Put the child in a comfortable position.
  • Check vital signs every ½ to 1 hour for first 4 hours.
  • Remove articles from bedside and keep it clean and ready to send it to CSSD.
  • Segregate generated Bio-Medical Waste as per the HIC policy.
  • Label the specimen, record in the pathology register and send it to pathology.
  • Get an X-ray chest done.

Monitoring

  • Note any complications.
  • Record vital parameters before and after the procedure.
  • Any medications administered.
  • Size of the tube used.
  • Fluctuations in the water seal chamber – Colour and amount of drainage.

Documentation

  • Nurse’s Observation Sheet.