by 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.

at my hospital,only the cardiac surgeon removes the chest tubes. The RNs assist, and provide education and support to the patient, but we dont remove the tubes.

At my hospital the cardiac surgeon or one of his PAs are also the one who pulls chest tubes. I have personally never done it nor have I been trained to remove chest tubes.

The NPs and CNS remove the chest tubes, there was an idea that a CT removal protocol was going to be devised, so that the staff RNS could do it, but have not seen it yet....

At the hospital where I worked ICU, RN's could pull the tubes. I used to, until one day the mediastinum tube would not come
out easily. After the surgeon came in we sedated the pt, and the surgeon gave the tube a very firm yank, then another and another. After the 3rd or 4th yank the tube came free. Upon inspecting the tube it was nearly torn in half about 3 inches from the distal end. It seems that it caught on the sternal wires and was hung up and pulling it free ripped it. After that lovely experience I made sure I pulled the tubes only when the surgeon was going to be available. By all means, if you are uncomfortable with the procedure, you should not do it, at least until you get the training you feel is necessary.

bob

The surgeons pull the chest tubes at my hospital. Nursing helps with the set up and instructing the patient on what to expect and applying the dressing. Thankfully, our surgeons are too controlling to even consider delegating that task...

Peace

In our CCU, RNs that have passed a hospital competency test are able to pull chest tubes with the doctors order.

Your state board of nsg. must approve this, then you must have a didactic training, lecture, then demonstrate competency 3 times with a "checked off" nurse prior to pulling on your own. I would never do this without written policy and the above procedure.

"Just say no if the above are not in place... what other nurses do are on them

I pull my CABG patients' CTs. I was trained by our surgeons, and I never pull them until I know at least one of the surgeons is around -- just in case. I have never had one 'catch' on anything. . .2ndcareerRN, that incident sounds horrible! Yikes!

Your pal,

Sherri

I just wanted to add that our surgeons are now using Blake drains as a 3rd CT. When the CTs are pulled, we put the Blake to a Jackson-Pratt suction thingy and it gets pulled by the RNs the day the patient goes home.