chest tube removal - page 3

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   heartICU
    Just like CRNASoon, all RNs in the unit I used to work in also pulled chest tubes, rarely had a problem.
  2. by   jewelcutt
    In our CVSICU RN's pulled chest tubes daily. We have such a busy heart center that it was necessary, it's in the policy and we were checked off on it. Sometimes we would pull all of them, or just one and y the others together, we also pulled blakes. In fact, we pulled all central lines, arterial lines, sheaths, femorals, and ET tubes.
  3. by   Specials Nurse
    Hello, I am a Special Procedures Nurse and I am currently developing policy and procedure for chest tube removal within my institution for the special procedures nurses. Also, I am looking to develope competencies for our Nurses to be evaluated in order to be signed off internally for chest tube removal with supervision and then on their own once competencies are meet. If you have any institutional guidelines, policies or competencies. Let me know, I would love to look over them in order to help advance nursing practice within our institution.
    Thanks
  4. by   CVICURN2003
    Rn's in our unit must be checked off by a CV surgeon first, then a PA then a nurse educator. These are commonly the very experienced "heart" nurses. I have never had a complication. We do not pull epicardial pacing wires though. We also pull sheaths, ET tubes, a lines, swanns and introducers. If we pull htree at once We have two nurses doing it for patient comfort. It is not standard practice at my hospital to do a PCXR after CT removal unless you suspect problem. We usually put MCT PO Day #1. PCT a couple of days later (no air leaks or MD pulls .
  5. by   APNgonnabe
    In my facility we as RN's pull drains that are in the mediastinal space and not the pleura. Obviously if you did not feel right about something then don't do it. Typically these are pulled during the day (after CV surgeon orders it) so they are around God forbid.
  6. by   Specials Nurse
    thanks for your feedback. Currently the data I have found indicates, the chest tubes that are removed by nurses, seem to be placed by surgery and are a larger french then the ones used in specials. The Size ranges for us, are 8FR-14FR. THese are the same type tubes that we use for nephrostomies, abcess drains and chest tube drains. We have always removed abcess drains and nephrostomy drains in our department. The next step is to removel chest tubes, since they are the same tube, but of course with the supporting protocols.
    Thanks
  7. by   Specials Nurse
    Is it possible to get hold of those competencies for the policy.
    Thanks,
    SPecials Nurse
  8. by   Specials Nurse
    Is it possible to get hold of your institutions policies, standards of care, and competencies for this practice.
    Thanks,
    Specials Nurse
  9. by   BBFRN
    Quote from Specials Nurse
    Is it possible to get hold of your institutions policies, standards of care, and competencies for this practice.
    Thanks,
    Specials Nurse
    Have you considered bringing some of your cardiac surgeons on board with helping to develop your facility's P&P on this? That's probably going to be your best bet in getting this done.
  10. by   Specials Nurse
    I would involve cardiac surgery, however the Interventional Radiologists are the one's who put in the tubes in our department.
    Thanks,
    Specials Nurse
  11. by   AnnaN5
    I am in my last semester of nursing school and I just finished up a rotation on a cardiac step-down floor. The nurses on that unit pulled chest tubes but did not pull the pacer wires. The PAs pulled the pacers.
  12. by   Specials Nurse
    Does anyone place chest tubes for radiology or special procedures that are 8-14fr. And if so, does your institution have protocols for removal and a competencies sign off sheet.
    Thanks,
    Specials Nurse
  13. by   guapo_23_
    HI i work in a cardiac surgery area, and yes we do remove chest drains 24-48 hours post cardiac surgery. although you have to be assesed competent to perform it.

close