chest tube removal

HeartmenderRN · Apr 17, 2002

at my hospital,only the cardiac surgeon removes the chest tubes. The RNs assist, and provide education and support to the patient, but we dont remove the tubes.

nursev2 · Apr 20, 2002

At my hospital the cardiac surgeon or one of his PAs are also the one who pulls chest tubes. I have personally never done it nor have I been trained to remove chest tubes.

egmillard · Apr 20, 2002

The NPs and CNS remove the chest tubes, there was an idea that a CT removal protocol was going to be devised, so that the staff RNS could do it, but have not seen it yet....:roll

2ndCareerRN · Apr 20, 2002

At the hospital where I worked ICU, RN's could pull the tubes. I used to, until one day the mediastinum tube would not come

out easily. After the surgeon came in we sedated the pt, and the surgeon gave the tube a very firm yank, then another and another. After the 3rd or 4th yank the tube came free. Upon inspecting the tube it was nearly torn in half about 3 inches from the distal end. It seems that it caught on the sternal wires and was hung up and pulling it free ripped it. After that lovely experience I made sure I pulled the tubes only when the surgeon was going to be available. By all means, if you are uncomfortable with the procedure, you should not do it, at least until you get the training you feel is necessary.

bob

Fgr8Out · Apr 21, 2002

The surgeons pull the chest tubes at my hospital. Nursing helps with the set up and instructing the patient on what to expect and applying the dressing. Thankfully, our surgeons are too controlling to even consider delegating that task...

Peace:)

zambezi, BSN, RN · Jul 27, 2002

In our CCU, RNs that have passed a hospital competency test are able to pull chest tubes with the doctors order.

nimbex, RN · Jul 29, 2002

Your state board of nsg. must approve this, then you must have a didactic training, lecture, then demonstrate competency 3 times with a "checked off" nurse prior to pulling on your own. I would never do this without written policy and the above procedure.

"Just say no if the above are not in place... what other nurses do are on them

st4304 · Aug 2, 2002

I pull my CABG patients' CTs. I was trained by our surgeons, and I never pull them until I know at least one of the surgeons is around -- just in case. I have never had one 'catch' on anything. . .2ndcareerRN, that incident sounds horrible! Yikes!

Your pal,

Sherri

st4304 · Aug 2, 2002

I just wanted to add that our surgeons are now using Blake drains as a 3rd CT. When the CTs are pulled, we put the Blake to a Jackson-Pratt suction thingy and it gets pulled by the RNs the day the patient goes home.

Dazedgiggle · Aug 12, 2002

I work on the CV-surgical step down unit....nurses who have been checked off on the competancy and supervised pulling three sets of tubes (this must include pulling Argyles or Atriums, converting a blake to JP and pulling the JP when appropriate) do all D/Cing of chest tubes. Nurses who are not comfortable do not have to do it, but it really is nice not to have to wait for the surgeons to FINALLY have time to do it!! In our hospital surgeons do not have to be in the building for us to perform this procedure. RN's also pull epicardial wires where I work, for this the surgeons do need to be in-house in case of tamponade. I can safely say that there has never been a problem with RN's doing these things...we all know when NOT to pull and there has never been a complication. :)

DIPLOMATICRN4HIRE, MSN, RN · Aug 12, 2002

Surgeons or a PA removes the chest tubes, even in Or the PA removes the chest tube, I havent known of a case where the Rn was covered to do such a procedure unless they worked for the surgeon and even then the PA did it, and the Nurse assisted.

Zoe