Chest tube help

[RNLola035]

I had a patient who had a chest tube last night, I believe it may have been an Atrium. Anyway the order called for 20cm of water to suction. There was NO water in the suction part of the drain, but there was only water in the water seal. The dial on the Atrium was set to 20cm and was hooked up to suction. The drainage from the patients chest was indeed draining as expected.

My concern is I have never seen a chest tube that didn't actually have water filled to the 20cm line when the order called for it. I had several nurses look at it and they said it was fine. Does this make sense to anybody else?

[Mike A. Fungin RN]

My concern is I have never seen a chest tube that didn't actually have water filled to the 20cm line when the order called for it. I had several nurses look at it and they said it was fine. Does this make sense to anybody else?

Yeah, that's the way some of them are designed. It was probably an Atrium Oasis or Express. There's a dial for setting the amount of suction you want, as opposed to filling a chamber with water. Atrium actually has some really great educational material on their site (Atrium Medical: Chest Drainage) if you want to check it out.

[murphyle, BSN, RN]

You were dealing with a dry suction system. As opposed to the old "wet suction" type of chest drain that used a water column to regulate the suction, dry systems use a pressure manifold that's regulated with a dial. Systems of this type include the Atrium Oasis and Pleur-Evac A6000.

Management of this type of system isn't that different from managing a wet suction system. Ensure that the dial remains set to the ordered level of suction, monitor the drainage and mark levels as ordered.

Hope this helps!

[Reno1978, BSN, RN]

It's a dry system. We use these almost exclusively now at the hospital I work at. Like others have mentioned, the suction amount is set by the dial on the collection container, and the water seal chamber is filled with water. The models we use require the wall suction to be set at -80cmH2O or higher - usually they're just cranked up on high since the actual pressure regulator is in the chest tube collection container.

[RNLola035]

Ahhhhh ok thanks so much! I didn't know those existed!

[GilaRRT]

We just started flying patients with dry seal devices over the past year or so. Absolutely love them.

[simboka]

Yeah, that's the way some of them are designed. It was probably an Atrium Oasis or Express. There's a dial for setting the amount of suction you want, as opposed to filling a chamber with water. Atrium actually has some really great educational material on their site (Atrium Medical: Chest Drainage) if you want to check it out.

I've just plain sat down and watched these videos with orientees before, there're awesome. And don't forget that when to suction, the red bellows should expand too.