Chest Tube Drainage System - The chest tube drainage system is use for treating conditions that disrupt the space of pleural. The body is able to absorb the small volume of fluids or air over time. However, the larger volume of fluid will limit lung expansions that able to cause respiratory distress. In some cases that extreme, the tension of pneumothorax is able to develop. Chest tube also use for preventing or mitigating the complication after operations and surgery. For example, after cardiac surgery or trauma in chest that likely chest tube inserted to drain blood and prevent cardiac tamponed.
The chest tube drainage system complication
There is potential complication in chest tube drainage system insert. It able to cause bleeding but is usually minor and resolve in its own. The nurse need to aware for the infection risk that increase with the tube placement duration. The regular dressing that changes can help the prevention of site infections. Note for the changes in drainage amount and character that indicate for bleeding increase or for a new on-site infection. Avoid the aggressive chest tube manipulation, include milking and stripping because it able to generate extreme negative tube pressures. It also recommended to avoid tube clamping.
Type of chest tube drainage system
There are three type of chest tube drainage system that common in use.
- Water seal chamber or one way valve system. This is the typically middle chamber with water seal. This drainage system allows the air to exit to pleural space on exhalation and keeping the air from entering to the mediastinal space or pleural inspiration. To maintain the adequate water seal, it should keep the drainage system upright in all times and ensure the fluid in in water seal chamber in the recommended level. Bubbling in the water seal indicates the air leak.
- Wet or dry suction control. This is the traditional closed chest tube drainage system that regulate the amount suction by with the water height in the suction control chamber. This is typically located in the left side system. To setting up this chest tube drainage system, fill the suction control chamber with sterile water or with the recommended sterile fluid into prescribed level. Typically, for adult use it is about 20cm marks. Infant, kid and fragile lung patient tissues require lower level. It is important to monitor the water level of suction control chamber and if it is necessary replace it to maintain the appropriate suction amount.
- Mobile chest drain. This is use for patient that requires ambulation or goes home with chest tube drainage system. The device is accommodated with small or partial pneumothorax and it does not collect fluid.
Removal of chest tube drainage system
- The chest tube removal is able to hold when there is a significant in;
- Improved respiratory status
- Symmetrical rise fall of the chest
- Decreased chest tube drainage
- Bilateral breath sounds
- Absence of bubbling
- Improved chest
See also: What is Acid Mine Drainage?
When take the chest tube drainage system removal, ensure that it has informed well to the patient. This will reduce the patient anxiety and premedicated for patient to relieve pain after removal chest tube drainage system.