Talcing or TPAing Chest Tubes.

  1. 0
    Recently I was given an order to TPA and the later to Talc (pleuradese) a double chest tube. I declined as this falls outside my experience. While I have assisted with the procedure and taken care of the patient following the procedure, I had never physically injected the meds.

    Is this something that falls inside of a staff nurse's scope of care?
  2. 2,237 Visits
    Find Similar Topics
  3. 4 Comments so far...

  4. 0
    We strip mediastinal CT's all the time to hopefully prevent clots, but I've never done what you're talking about and actually never even seen that done.
  5. 0
    not within the scope of practice in pa to instill anything into chest tubes. assisted the docs many times when worked pulmonary unit. talc worked well >95 %, better than antibiotic. turning side to side every 15 min, even to prone if can tolerate helps to distribute talc and promte internal scaring to seal lung.

    chemical pleurodesis links:
    http://www.cancerhelp.org.uk/help/default.asp?page=5291
    http://www.vh.org/adult/provider/int...leffusion.html
    http://www.medscape.com/viewarticle/424726_9
    Last edit by NRSKarenRN on Mar 10, '05
  6. 0
    Our Interventional Radiologists did this, or instructed the Residents how to do it (although some of them I'd not trust with stopcocks, if you KWIM). I would NOT do it. Check w/your state BON.
  7. 0
    Quote from NRSKarenRN
    Not within the scope of practice in PA to instill ANYTHING into chest tubes. Assisted the docs many times when worked pulmonary unit. Talc worked well >95 %, better than antibiotic. Turning side to side every 15 min, even to prone if can tolerate helps to distribute talc and promte internal scaring to seal lung.
    Well, I am on assignment in Florida, but I refused as I am not comfortable with doing this procedure.

    As I work oncology and most of my pleural effusion pts are malignant in origin or ca related, the success rate on pleuradesing is not nearly so good.

    I was just amazed that this facility will not permit cardiac gtt on the onco unit and are very fussy on KCL boluses/cardiac pushes on the onco unit, but would ask us to TPN/talc a chest tube.


Top