- Assess patient for respiratory distress and chest pain, breath sounds over affected lung area, and stable vital signs
- Observe for increase respiratory distress
- Chest tube dressing, ensure tubing is patent
- Tubing kinks, dependent loops or clots
- Chest drainage system, which should be upright and below level of tube insertion
- To assess air leak
- To quickly empty or change collection bottle or chamber; performed by soldier medic who has received training in procedure
- To change disposable systems; have new system ready to be connected before clamping tube so that transfer can be rapid and drainage system reestablished
- To change a broken water-seal bottle in the event that no sterile solution container is available
- To assess if patient is ready to have chest tube removed (which is done by physician’s order); the solider medic must monitor patient for recreation of pneumothorax.
- When the chest tube is removed, immediately apply a sterile
- occlusive petroleum jelly dressing. An occlusive dressing prevents air from reentering the pleural space through the chest wound
REFERENCES:
Carroll, P. (1995). "Chest Tubes made easy". RN, December. pp. 46 -55.
Gordon, P.A., Norton, J.M. & Merrell, R. (1995). Refining Chest Tube Management: Analysis of the State of Practice, Dimensions of Critical Care Nursing. 14 (1), pp. 6 -12.
Kozier, B. & Erb, G. Eds. (1993). "Monitoring a Client with Chest Drainage". Techniques in Clinical Nursing. pp. 817 -821.
O'Hanlon-Nichols. "Clinical Savvy: commonly asked questions about chest tubes". American Journal of Nursing. May 1996. 96, pp. 60-64.
Springhouse Corporation (1991). "Chest Drainage", Procedures Video Series. Springhouse PA
