Chest Tube Help please

JenKatt · Jun 15, 2005

We had a patient not that long ago who had a chest tube for months after a TE fistula repair. He had a chylothorax post op that would not heal and repeated surgery was not an option (it's a very long twisted story). So the little one wound up on Portagen and m,ultiple chest tubes. It finally did heal and he went home.

You're role as an RN during insertion and care depends on your facility but usually requires ensuring proper placemnt of the tube after it's in (checking lung sound frequently) ensuring good oxygenation, pain control (often an uphill battle), and patency of the system. And if I wasn't coming off my fourth night on I'm sure I could think of more. Your duties during insertion includes helping if not setting up the field, making sure you have life support ready if need be. Often the infant we need sedation prior to insertion which will also fall for you to do, whether it's morphine (what we use) or something else.

As far as your preceptor, if you can't talk to her, go to your nure manager and tell him/her that due to differences in personality that you would like a new preceptor. Try talking to your current one again and if you get no where, stand up for yourself and demand a decent orientation. Not only are you doing yourself a disservice by not learning, you're doing your patients as well.

I'm here if you need someone to talk to that has been there and done it. Good luck! And we're all not that mean!

LilyRN · Jun 23, 2005

Can someone tell me how to check a chest tube for a leak. How is it fixed or what harm could it cause the baby (it's probably obvious but I'm asking anyway)
Why would a baby with a TE fistula repair need a chest tube once they've done the repair.
Basic responsibilities of the RN in chest tube care.
Role of nurse in helping the doc put one in.
Thanks. I'm new to NICU and my preceptor is so MEAN. I asked her some of these questions and well...I need your help. Sorry I know they are stupid questions but......
Laney whose a new grad struggling in NICU

It seems that whenever I have an infant with a chest tube - we've changed drainage systems. So I use the manufacturers provided video that talks about how their particular system works, i.e. leaks and such.

I also have "google searched" a chest tube drainage system and have gotten loads of web sites that are helpful. (I'm lucky, we are allowed to use the internet at work. I realize that is not always the case.)

Whenever there is something going on in my unit that I'm not familiar/comfortable with I try and watch or help out. I also ask co-workers to help/participate in care with those things I'm not skilled or familiar with.

I've found that while some co-workers have limited interpersonal skills - most welcome the chance for me to pick their brain or just the help!

Hang in there, it gets way better most days.