Chest Tubes and Clamping
- 0May 18, '03 by nightingaleOkay.. I feel REALLY stupid (after I was "scolded" in report) but.. is it okay to clamp a chest tube temporarily to allow the patient to walk or sit away from the wall suction?
- 0May 18, '03 by susanmaryI've never done it. I won't even take a patient off of suction without an order, ex. "may be off suction for ambulation, for chest x-ray, etc. then placed back to suction." Don't want to cause a tension pneumo, crepidous, etc. And I don't take patients with air leaks off suction -- the chest x-ray will be done at the bedside. You can always get extension tubing, tape all chest tube connections, etc. so that the patient can ambulate in the room, get out of bed, etc. You really need to check your facility's policies and procedures. Forget the "scolding" and turn this into a learning experience.
- 0May 19, '03 by NRSKarenRN, RN, BSN AdminTube Clamping
The chest tube should never be clamped. Doing so in a patient with a residual pleural leak, even if small, can lead to a tension pneumothorax and resultant cardiac arrest.
Clamping, stripping, and irrigating:
Clamping the chest tube is not done except briefly to change the chest drainage container and to check for air leaks. The clamp needs to have rubber sleeves over its jaws so as not to damage the chest tube.
NEVER CLAMP THE CHEST TUBE IF THERE IS AN AIR LEAK FROM THE PATIENT.
Stripping the tubes(with mechanical strippers) to promote drainage through them is not favored anymore as it causes high negativity within the chest cavity which may damage the tissue.
Irrigation is usually only done by the surgeon.
American College of Chest Physicians:
Only 41% physicicans will clamp chest tube once lung inflated prior to removal...
***Chest Tube Care and Monitoring
UK--PORTEX waterseal setup:
***Nursing Management of Chest Tubes Who gets a chest tube?http://academic.cuesta.org/mscott/chstube.PDF
- 0May 19, '03 by nightingaleThank you for all the valuable info. I knew I could count on you for positive feedback.
I am sure I will hear more about this when I go back on Tuesday but I will have these copies to bring to report.
I know I have clamped before but will never do again without an order (and may refeuse to do so).
Thank you all! (Especially Karen for the references).
- 0May 19, '03 by lee1Originally posted by nightngale1998
Okay.. I feel REALLY stupid (after I was "scolded" in report) but.. is it okay to clamp a chest tube temporarily to allow the patient to walk or sit away from the wall suction?
Otherwise you just UNDO the suction to water seal so at least it is still draining by gravity
If you clamp you run the risk of clotting off the tubing and tamponade