Chest Tube Air Leak

[middlekane]

I'm a nursing student and a PCA and one of my pts. with a chest tube after a thoracotomy told me that the doctor just came in and said that they had an air leak and the tube would have to stay in a little longer. They then asked me what an air leak was and where it was coming from. I started to answer then realized I didn't know if the air leak was coming from the outside and entering the pleural space or if it was coming from the lungs. I assume it's the latter, an opening from the lungs into the pleural space, but I'm not sure. Can someone explain it to me or give me a good resource on it? Thanks,

[meownsmile, BSN, RN]

Your best bet is to go to the patient chart and read the physicians notes. His daily dictation should give you the information you need. The patient is most likely still having some air inthe pleural sac which is not letting the lung expand completely. By air leak he is referring to the air that remains in the pleural sac. It could be the thoracic incision isnt completely sealed at the incision making some air continue to be leaking into the pleural sac. As i said, the best place to start is the physicans daily dictation.

[gitterbug]

remind the patient that the doctor needs to answer the questions too.

[seagull]

You should also find time to educate yourself, reading about it will enanble you to better deal with them. good luck

[jmgrn65, RN]

It is common after a Thoracotomy to have an air leak. because they are usually taking a part of the lung out, the remainder is sutured closed so it isn't always an occulsive seal thus air escapes. It just takes time.

however it is the doctors job to explain it. You as PCA and a student have to remember to step back and not answer things you know because you are a student. It can come back and bite you :)

[rita359]

Tell the patient you will get the nurse to explain the air leak. fyi the chest tube is in to remove post op fluid and air that escapes from the incision on the lung before the lung heals. When air no longer escapes from the alveoli into the pleural space the leak into the pleurovac will stop and the physician will be ready to remove the chest tubes.

[nursynurseRN]

what kind of chest tube was it? was it to water seal or suction? You come sometimes check if there is a water leak by pinching part of tube and seeing if the bubbling stops. Sometime air leaks can be becasue aof a leak in the tubeing.

[NRSKarenRN, BSN, RN]

check out notes on icu nursing : chest tubes 4/6/04

easy to understand info for novice nurses ...and those that need refresher.

rita359 gave good advice: anytime patient asks you something and are unsure/have not been taught yet in nursing school, inform them that you will have their nurse answer the question.

[VegRN]

Karen, that was VERY informative. Thank You.

[rainfallrx]

Thank you Karen I am very uncomfortable with chest tubes and found the information quite helpful! Thanks! :)

[JBizzleRN, ADN, RN]

Quick thought about chest tubes...the more and more chest tubes I take care of the more I realize that some nurses are getting slacked in their precautions....I go in a room there is no vasaline gauze at the bedside, no hemostats or chest tube clamp anywhere....seriously.....this is dangerous to the patient. I always get the same response when I ask about it .."Well I was going to do it, but I guess I forgot"