chest tubes - page 2

1. 
   Aug 11, '08

   Quote from Dinith88

   Thats incorrect.
   
   Tamponade is a real issue post-CABG...which is a primary reason why these patients have (usually) 2 mediastinal chest-tubes.
   Clamping these tubes immediately post-op can quickly lead to tamponade...as these patients often have elevated PTT's, etc...and can dump a good amount of blood in the first few hours...and an could be an even more pressing issue should the patient have a bleeding/leaky graft..)

   
   My goodness, if i ever clamped the mediastinal CTs on a fresh heart, the surgeon would clamp my @**
2. 
   Aug 11, '08

   Quote from OptimusPrime

   Clamping a chest tube will never cause a tamponade, it's just impossible. The thoracic cavity can hold well over the amount of blood circulating in our bodies. Therefore, one could potentially hemorrhage out, but not tamponade.

   I've actually seen it happen. We came onto shift with the patient going downhill quickly and within a few minutes the patient went into tamponade. Come to find out the CT's had not been connected to any kind of suction and apparently the day nurse didn't move the CT's to ensure patency/keep the drainage moving. That was a fun one...made me very glad I was not the primary nurse having to explain all this to the surgeon.
3. 
   Aug 12, '08

   I am a new nurse, and i have a question about collapsed lungs. What do you do when a chest tube does not work? What is the next step?
4. 
   Aug 13, '08

   Quote from missej2002

   I am a new nurse, and i have a question about collapsed lungs. What do you do when a chest tube does not work? What is the next step?

   http://www.teleflexmedical.com/ucd/n...leshooting.php
   
   Here's a pretty good trouble-shooting guide.
5. 
   Aug 13, '08

   i guess that i should clarify the question, there is nothing wrong with the chest tube, it is the lung. The lung re-expand and then re-collapsed, and has not re-expand since then and the tube has been in placed for a week.
6. 
   Aug 14, '08

   I think that falls into the realm of the doc's diagnosis and treatment, missej2002.
   
   You might ask him what the next step in treatment would be if the CT is not working to expand the lung. Most docs are glad to teach.
7. 
   Aug 14, '08

   Have they tried dry suction?
   
   What is the cause of the pneumo? Was it tension, trauma, or fluid related?
8. 
   Sep 29, '08

   Quote from eagle1953

   When taking a CT patient off suction for transport, do you clamp the suction tubing? or do you leave it open to air. And why? I am not talking about the water seal tubing, I am talking about the tubing attached to the wall suction. Need to know asap as I am getting conflicting answers from very angry doctors...........

   I think you are referring to the Argyle plastic tubing that connects the drain to the suction source, correct?. If you need to transport a patient, you have three options: Remove the suction tubing from the drain and transport the patient on water seal, something that may not be a good idea in a patient with large airleaks (ie.. lung reductions), transport with the suction tubing and connect to suction at your destination, or transport connected to portable suction (which I've never done). The determining factor is whether or not the patient can transport without unacceptable air accumulation off suction. Drainage of fluid from the thorax via chest tubes is first and foremost a gravity issue rather than one of suction.

Must Read Topics