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Maintenance of Chest drainage Chest Tube

Maintenance of Chest Drainage Tubes

In maintenance of chest drainage, A chest tube is a flexible plastic tube, is inserted through the chest wall into the pleural space or mediastinum through the doctor.

Maintenance of Chest Drainage Tubes

  • Ensure that the patient’s ICD drainage tubes are kept in a proper position.
  • Ensure that the tubing’s do not loop or interfere with the movements of the patient.
  • Ensure that the ICD bag is placed below the level of chest. In case of change of position, take care that the bag is not accidentally placed at a height above chest level.
  • Keep two artery forceps ready in order to handle any accidental disconnection of the tube.
  • Encourage good body alignment. When the patient is in a lateral position, place a rolled towel under the tubing to protect it from the weight of the patient’s body. Encourage the patient to change his position frequently.
  • Encourage patient to do the range of motion exercise of the arm and shoulder of affected side.
  • “Milk” the tubing in the direction of the drainage bag as needed.
  • Ensure that there is fluctuation (Tidaling) of the fluid level.
  • Empty out the contents every 24 hours preferably in the morning at 6 a.m. unless the doctor specifies not to empty out.
  • Subtract the amount of normal saline instilled before recording the results.
  • Refill the normal saline at the level of the marking and add few drops of Betadine in it for easy visibility of the fluid.
  • Fluctuations of fluid in the tubing will stop when –The lung has re-expanded.
  • The tubing is obstructed by blood clots or fibrin.
  • A dependent loop develops.
  • Suction motor on wall is not operating properly.

Removal of inter-costal drainage

Collect the following articles at the bedside –

  • Sterile Gloves.
  • Sterile Gauze.
  • Betadine ointment and lotion.
  • Scalpel Blade.
  • Ether
  • Dynaplast
  • Analgesic drugs, if ordered.
  • Dressing tray.
  • Explain the procedure to the patient.
  • Give analgesia prior to procedure, if ordered.
  • Provide privacy.
  • Wear unsterile gloves and remove the dressing. Ask the patient to take a deep breath and hold the breath while the tube is being pulled out.
  • After tightening the stitches apply Betadine ointment and apply dressing.
  • Ask for chest x-ray.
  • Replace the articles.
  • Document the procedure in nurse’s notes.
  • Any untoward reaction noted duration the procedure.