Suppose you had a patient, and you walked into the room during your shift and they were standing about, brushing their teeth or something, with their chest tube still in their chest but totally disconnected from the pleurovac system? You just hook it back into the pleurovac (given that is was still sterile?) I would call the physician, but what would your immediate interventions be?
This was a critical thinking question in my textbook, but the teacher never goes over them and now I'm curious. Thanks so much everyone
Mar 18, '06
We had a chest surgeon who used to intimidate any new nurses he spotted working on our unit by asking them questions like this. You get the end of the tube immersed in water immediately (water seal) or pinch it off and get it hooked back up to it's water seal fast. Get them back to bed. Swab the drainage port with alcohol or betadine and get the tube hooked back up to the water seal drainage system.
For laRN1. . .ideally, you connect the chest tube to a new drainage set up on an inspiration. It is safer, however, to clamp the tube very briefly while you make the change over despite what others have said in this thread. It's true that you need to make sure you remove the clamp. It is always a good idea that you assess the patency of a chest tube before leaving the patient's bedside by physically running your fingers along the tubing checking for kinks, checking the connections and noting the tidaling of water in the water seal compartment of the pleur-evac (if that is the drainage system you are using). You also don't want the tubing hanging down in loops over the side of the bed. You want it neatly coiled on the bed.
FYI. . .there is a CE article on chest tubes in the current March issue of Nursing 2006
. You can read the article on line for free at this website http://www.nursingcenter.com/prodev/...asp?tid=633945
Last edit by Daytonite on Mar 18, '06