chest tube orders
- 0Dec 7, '09 by morningstar5I work on a med surg floor. I have a question about chest tube orders. The pt got a CT for a pnuemothorax and when he came back with it the order read: "chest tube to 20cm of H2O pressure. No more than 20cm of water." The first nurse that had the pt put in the 20 cm of water and hooked up to the wall, which by the way I thought was what 20 cm of water pressure meant. The following nurse said that it should not be hooked up to the wall suction because it did not say to. She took it off the wall suction and left it to water seal only with 20cm of water in the chamber and every other nuse after left it like that. When I got the pt it was still like that. I asked my charge nurse and she said it should not be hooked to the wall suction. If any of you frequently work with chest tubes frequently I would appreciate your input. Thank you.
- 0Dec 9, '09 by classicdame Guidethey are right. Water seal at 20 cm may be all the patient requires. Is the tube high or low? If high, they are dealing with air. If low, you are dealing with fluids, like blood. Chest tubes on wall suction are more aggressive.
I recommend this website for free tutorial (good even if your hospital uses another type of equipment)
You might also search for the website for your particular vendor. Most have CE for nurses because if we have negative outcomes we tend to blame them, not ourselves, and their goal is to sell as many as possible.
- 0Jan 24, '10 by CrabbyPattyQuote from angelfish81I agree with Angelfish. Order should have been clearer; and if the MD is not there to clarify, someone should be covering for them who can clarify what the order should be.Ideally the order is supposed to read CT to -20 Low Cont Wall Suction. Or CT water seal. The tube is always at 20cm of water in the chamber. I think the MD needs to write it clearer.
Here's the site for Pleur-Evac CDU info: