chest tube removal - page 4

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   quijarz
    in my former work area in uk nurses do the chest drains removal, except for mediatinal drain, it's the doctors' job. we asked the patients to practice holding their breath for 3 seconds. then when confident already that they can follow we do the job.wounds should be closed as fast as posible to prevent air from going in.
  2. by   jmgrn65
    we pull all chest tubes except what radiology places. We pull pacer wires and central lines. We have competencies for chest tubes and pacing wires. Have been doing this for over 17 years, not any complications with chest tubes. One time couldn't pull pacerwires, surgeon did it, and apparently it became knotted.
  3. by   BellaCerraRN
    At our hospital RN's pull chest tubes. We follow a modified see 1, to 1, teach 1. First we watch 3, we help with 3 and then we do one under the supervision of our preceptor and the attending Doc. Then they sign us off. Within 30 days of pulling our 3rd we're required to teach one. If there isn't a new nurse to teach we have to walk another RN thru one just as if she's clueless and she's only allowed to do what we instruct her to do (to the point of danger), then we get critiqued on our instruction. We do this for just about every procedure on our ICU/CCU pathway.
  4. by   RNstudent86
    At my hospital there are a few units that pull them, mine being one. Just pull them out and tie up the purse strings.
  5. by   suanna
    R.N.s pull al the chest tubes here (as well as blake drains). No big deal, after the first half a dozen you will think of it as just one more thing you have to get done tonight. In 20 years in CVSICU I have only had 3 patients have any majior complication with CT removal. It is such an improvement in the patients pain status that I can't wait to pull the tubes.
  6. by   anurseuk
    In my ctc critical care the trained staff nurses can pull the tubes out once we've passed the competancies and even the clinical support workers can assist us and act as the second nurse.

    we hav nurse led removal (senior sister in charge) and it is usually done day one post op (the day after surg) as long as it meets our criteria. on the post op instructions it'll say if they want cxr's before or after or both (depending on surgeon)

    If there's still drainage and does not meet out criteria the doc needs to giv us the go ahead to take out drains.

    Personally I feel totally confident in removing them and haven't had any problems so far (touch wood) but if i did we hav a clinical fellow always on the unit
  7. by   Specials Nurse
    Sounds good, however we place chest tubes not post surgical. We place them for pleural effusion. If you have any protocols let me know. Thanks,
    Sid Prasad
  8. by   anurseuk
    Quote from Specials Nurse
    Sounds good, however we place chest tubes not post surgical. We place them for pleural effusion. If you have any protocols let me know. Thanks,
    Sid Prasad
    I'm a 30hour flight away from work but can certainly forward the protocols to you once I'm back
  9. by   obynna
    I work in a teaching hospital in Nigeria,The cardiothoracic trained nurses were taught how to remove chest tubes,but at the long run,only the surgeons end up doing the procedure.
  10. by   ghmccart
    I pull mediastinal tubes in my OHS patients, not pleural tubes however. Try to pay attention to the difference on XR or communicate with doc.
  11. by   joeyzstj
    In my unit we pull all chest tubes, PA caths, lines and pretty much anything else. We assist with Balloon pump DC's. We pull pacing wires, ect, ect. I work in a great CVICU where we have a lot of autonomy...............you had just better be smart about what you do or you will pay for it.
  12. by   trippinwitchu
    In my unit, RNs can remove chest tubes, however, you must attend training, and then you have to have 3-4 witnessed CT removals before you can do them on your own.
    Look at your state's scope of practice. Do not do anything without the proper training.
  13. by   cardiorn04
    At my hospital, we have a policy that RNs may pull mediastnal CT only. However, the surgeon or the PA usually end up pulling the mediastinal and pleural CTs at the same time. I have only pulled 3 mediastinal CTs in my career.:heartbeat

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