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Bubbling chest tubes while on suction



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May 30, 2009 05:10 AM

Bubbling chest tubes while on suction

by 234meme

Hello! Today I had a day 3 post CABGs who has had a persistant bubble/ air leak from his MSDT's (chest tubes) and hence the doctors wanted to leave the offending chest tube in. I understand that when assessing for a swing/ bubble I need to stop suction, but this patients bubble was absent when suction was off, and present when suction was on. The nurse who I handed over to said that this is not classified a a bubble, as it was not occuring while he was off suction. My argument was that regardless, a mediastinal chest tube should not be bubbling at all.
What are your thoughts, guys? Would you call this an air leak?
Cheers.


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1 Comment
No. 1
from bigredrn57
Old Sep 01, 2009, 01:19 AM

Default Re: Bubbling chest tubes while on suction
Originally Posted by 234meme View Post
Hello! Today I had a day 3 post CABGs who has had a persistant bubble/ air leak from his MSDT's (chest tubes) and hence the doctors wanted to leave the offending chest tube in. I understand that when assessing for a swing/ bubble I need to stop suction, but this patients bubble was absent when suction was off, and present when suction was on. The nurse who I handed over to said that this is not classified a a bubble, as it was not occuring while he was off suction. My argument was that regardless, a mediastinal chest tube should not be bubbling at all.
What are your thoughts, guys? Would you call this an air leak?
Cheers.
It is an air leak. I would take the dressing down and ensure it is patent and leave the patient on wall suction. The latest information I've read said not to use vaseline impregnated gauze around the chest tube, and only to tape the dressing on three sides to prevent crepitus. There is also some debate on whether the air leak will resolve better with or without suction. Sometimes though this is doctor specific. Some do some don't. It's best to call.
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