chest tube removal - page 2

I WORK IN A BUSY CCU/ICU DEPT. I HAVE A QUESTION ABOUT THE REMOVAL OF CHEST TUBES. DO RN'S IN YOUR HOSPITAL REMOVE CHEST TUBES S/P CABG 12-24 HOUR POST-OP? WE HAVE A COUPLE OF RN'S WHO FEEL... Read More

  1. by   crazyrn1983
    At the hospital where I work only the Surgeons and Pa's pull chest tubes. We do however have one Surgeon who wants to
    train the RN's to take over this task . To date no RN's have volunteered.
  2. by   Bermuda
    No thank-you... I have enough to do without expanding my job description anymore...with 5-6 tele patients on our super busy and super sick floor of 53 patients with all going for cardiac caths..stress tests and post cabg patients of 24 hours...I don't need to add that task..we do prepare; assist and dress the site and of course continue with the respiratory aspect of it...pulse ox/incentive spiro etc... enough already....
  3. by   HazelLPN
    None of our staff nurses do it on our own. We set up and assist with the procedure, but the surgeon or cardiac care clinition (advanced practice nurses who work directly with the suirgeons) pull the tubes.
  4. by   LuvbabiesRN
    On my unit (CV surg) RN"S can pull chest tubes... there has to be order of course ..
    The nurse has to be competent.. only the nurses who have been on the unit for years usually do it.. (and thats pretty much only the nurses on day shift) I think they have to take a course or prove competency... They can only pull mediastinal chest tubes though.. the PA's pull the pleural tubes.
    The RN's can also pull epicardial pacing wires... the PA's have to be on the unit though..
  5. by   HeartsGalore
    In our CVICU,the resident on call for that day pulls the cts early on dayshift, or occasionally, the more energetic ones pull them before am rounds, as they're finishing their nightshift. Very occasionally, the surgeon might. Everyone has them pulled before they're transferred to the IMCU- usually on their first post-op am. When I worked in the west,9 yrs ago,everyone was sent to the step-down unit with cts in place. Don't think they do it that way any longer though. I'm quite sure most nurses in the unit would not be interested in taking on this procedure,thank you very much! We've enough 'Delegated Medical Acts' on our plates right now, plus more being added - like doing our own dialysis- oh,joy!!
  6. by   mags-rn
    Nurses are playing increasingly important roles in the ICU/CCU. It is not uncommon to see nurses remove central lines or arterial lines or endotracheal/ trach tubes. Therefore I see no reason why they cannot remove Intercostal tubes. Like any procedure, it is important that the RN are properly oriented to the relevant issues and initially supervised by previously trained RNs.
  7. by   Geeg
    Don't readily take it on as a routine duty. It is just ONE MORE UNCOMPENSATED TASK!!!!! Plus, when you have to wait for the doc or the PA to pull it, you can buy some more time to get your work done, before you toss, oh I mean transfer, the pt out of the unit.
  8. by   kc ccurn
    Our "heart team" nurses must be checked off in their yearly competencies for pulling chest tubes before they can d/c a chest tube on our OHS patients. I don't think I've heard of anyone having any complications or problems, but that doesn't mean there haven't been any.
  9. by   Carlos RN
    Either the surgical interns or the NP's on the cardiothoracic service pull the chest tubes 12-24 hours s/p CABG in our unit.
  10. by   cabgrn2
    Quote from corkyrn
    I WORK IN A BUSY CCU/ICU DEPT. I HAVE A QUESTION ABOUT THE REMOVAL OF CHEST TUBES. DO RN'S IN YOUR HOSPITAL REMOVE CHEST TUBES S/P CABG 12-24 HOUR POST-OP? WE HAVE A COUPLE OF RN'S WHO FEEL COMFORTABLE WITH THIS TASK. I AM NOT. I NEVER HAVE BEEN CHECKED OFF OR TAUGHT THIS PROCEDURE ON A FRESH HEART.
    All 3 CT's are removed at once by the PA or MD. They are removed at the same time becuase the amount of pain is not associated with the # of tubes removed but the actual removal. So if they were removed separately the patient would have the same amt of pain 3 times. We give pain med immediately prior to removal. We have a couple of Dr's who in addition to pain med give 1-2mg of Versed. The patients that recieve the versed do not usually even remember having their tubes pulled.
  11. by   CALAYCAY
    Patient files: Radiation treatment last year blood stream due cause anaerobe tumor; this year spur treatment. Does radiation affect the effectiveness of the medication indicated? How long does radiation last in the blood stream? What caused Nubain mixed with LR to be an antagonist?-CALAYCAY
  12. by   CALAYCAY
    Patient file:

    2 0 0 3
    Diagnosis: anaerobic tumor, perforated appendix, inferior vena cava
    tumor, ischemia, inflammed veins
    Treatment: surgery with radiation - blood stream(2 half-liters bottle)
    2 0 0 4
    Diagnosis: spur formation
    Treatment: surgery
    Medication: Nubain, LR

    Question:
    What makes Nubain an antagonist?
    Is it due to allergic reaction/adverse effects?
    How long does radiation treatment last?
  13. by   CRNAsoon
    All RN's in our unit pull chest tubes, after the order has been written and the x-ray has been reviewed. No problems yet.

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