Removal of surgical vacuum drains

[ayemmeff]

Been taking these drains out for years and years,with no problem at all,then suddenly i had a patient who it REALLY hurt (30 year old female post right hemi-colectomy for Crohn's disease)

Did the usual things,

-Adequate pain relief

-De-vac-ed drain

-Advised patient on what to expect (without terrifying her)

-Big breath in,then blow it out as drain was removed(patient not me!!!)

We had to prise her fingernails out of the ceiling tiles!

I've had one of these drains myself(post emergency c-section), so I always have a great deal of sympathy for these patients,and I'm just wondering if anyone has any special "tricks" to minimise the pain/distress removal can cause.

Still feel bad about it now,4 days later!(patient is doing great and d/c tomorrow)

[flowerchild]

ayemmeff,

Don't feel so bad. You did everything that I know of to assist the patient to tol the procedure. I have noticed that the amount of discomfort seems to be r/t three things; Patients pain tol, the surgical procedure that was done and the location of the tube. Colectomy pts do have more pain than an appy or others. Nephrectomy pts seem to complain more than other post ops but not as bad as the colectomys when the drain is d/c'd. JMO.

Since your patient is doing well, you can take credit for a job well done! (Pat on the back from me to you.) I have taken out lots ofj drain tubes too and it always scares me when the patient does as you described. There is a couple of things I do with patients before drain removals and other painful procedures that might help. I have them close their eyes, do relaxation breathing exercise, then tell them to think of the most beautiful place that they love that is very relaxing, like the beach, or standing atop a mountain. I even ask them if they are at the place before I start. I always tell them everything I am going to do before, answer thier questions to help alleviate any fears and tell them what I'm doing to do during the procedure. I use a soft voice. Sometimes soft music can help too. Remember that there is always a patient that none of this will work for, I just watch the screamers closely afterwards to make sure there is not a complication, oh and I tell the doc. Happy Holidays!

[flowerchild]

One more thing I just remembered. The longer the tube is in, also can r/t the amount of discomfort.