chest tube water seal vs gravity drainage

Specialties Med-Surg


I'm pretty sure I know the answer already, but I just wanted to confirm with a few other nurses out there. At my hospital, when I have a patient with a chest tube, I pretty much see one of two orders for it. 1) 20cm H2O suction or 2) "water seal". When the MD puts it as "water seal", he means to put it to "gravity drainage" right? 90% of the nurses that I work with are pretty unfamiliar with chest tubes, so they all pretty much couldn't give me a confident answer. I pretty much just see the Atrium Oasis Dry Suction chest tubes on my floor, so when I see the "water seal" order, i'm assuming the MD just wants me to D/C suction and keep it off, and let gravity remove any excess air or blood/fluid in the pleural space. I know the water seal is in place with our without suction to prevent any air from flowing back in the pleural space. I also read that there is a positive pressure release valve built into these chest tubes that automatically/passively removes excess air from the pleural space without the use of suction. So, when the MD wants the chest tube to "water seal" he pretty much means that he wants it to "gravity" correct?

Specializes in Medical-Surgical/Float Pool/Stepdown.

This thread from a little while back as some really good info in it, I also attached a link about chest tubes that I found to be pretty cool and informative

Specializes in NICU.

Yes, water seal mean "to gravity", no suction.

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