Chest tube to suction?

[traumamomtx30]

If a patient has an order for a chest tube to 20cm wall suction does it make a difference if it's connected directly to the suction regulator or if it's connected to a canister (such as a canister for NGT drainage)? Will the suction be the same?

[PICNICRN, BSN, RN]

I have always been taught to take the canister off when using chest tube sx as the canister creates too much dead space. So, you would just hook the CT directly to the SX regulator and put it on continuous sx until your drainage system goes to 20 cm.

[wooh, BSN, RN]

We use the canister. Then turn up the suction until you have a "gentle rolling" of the bubbles.:)

[kvsherry]

I have only used the canister. It may be because its getting late, but I'm having trouble visualizing how the hook-up would work without it.

[suanna]

We just hook the chest tube suction line directly to the wall suction. The pleurevac serves as the canister. You set the "20cm" of suction by the pleurevac regulator.

[Nightcrawler, BSN, RN]

It doesn't matter which way you do it as it is the level of the water in the chamber that determines the amount of suction. The water can be boiling and roiling away and there will be no more suction than if there is just a light bubbling, so it really doesn't matter whether you use the canister or not

[Boston-RN, RN]

We leave the canister in. The chest tube has a dial you set for the amt of suction you want in the tube. The wall could be turned up to 100 but you'll only get 20 if thats what you set it to.

[mpccrn, BSN, RN]

doesn't matter if it's a direct line to the vacuum regulator or hooked to a canister....the -20 cm comes from the water level in the pleura-vac. a gentle rolling bubble is all that is required. :redbeathe

[meandragonbrett]

doesn't matter if it's a direct line to the vacuum regulator or hooked to a canister....the -20 cm comes from the water level in the pleura-vac. a gentle rolling bubble is all that is required. :redbeathe

You don't have to have a rolling bubble of the water level at all if the drainage chamber has a dial on it to control the amount of suction.

[nurseklw72]

We make it a habit to connect the chest tube to a canister and the canister is connected to wall suction. We do this for chest tubes to bottles or pleuravacs and for NG suction. We had an incident where someone couldn't remember that NG suction should ALWAYS go to the canister and they set it up so that gastric juice got sucked straight into the wall. YUCK!

[kristen929]

You don't have to have a rolling bubble of the water level at all if the drainage chamber has a dial on it to control the amount of suction.

Right, ones with dials are "dry/wet", meaning no water needed for suction control, just dial it up to the correct level; ones with two water chambers are wet/wet, meaning water needed for suction and for the water seal.

With the wet/wet ones, the level of the water in the chamber determines the suction amount and gentle bubbling is all you would need (or want, vigorous bubbling will just cause the water to evaporate faster).

I don't think it matters if the canister is still attached. Just dial the suction up to the point where you get a gentle bubbling in the suction control chamber.

[Nightcrawler, BSN, RN]

You don't have to have a rolling bubble of the water level at all if the drainage chamber has a dial on it to control the amount of suction.

This is only true of the dry suction chambers that have a dial instead of a water chamber.