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Discussion

chest tubes

Hi can any one clear me if we can clamp the tubes or not what are the occassions we dont clamp it?

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We usually only clamp a tube for ambulation purposes, or to check how well the pt. can tolerate it being clamped as an indicator if it can be DC'd.

we also clamp to change the receptacle[atrium container]

we ambulate off suction, not clamped

Depends on your unit policy. We only clamp to change receptacles or to remove the tubes.

I've had several pneumonectomy patients who had orders to keep their chest tubes clamped, otherwise, we only do it to change out the atrium.

When taking a CT patient off suction for transport, do you clamp the suction tubing? or do you leave it open to air. And why? I am not talking about the water seal tubing, I am talking about the tubing attached to the wall suction. Need to know asap as I am getting conflicting answers from very angry doctors...........

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We don't clamp it. Why would you?

The only time you should clamp a chest drain is with pt's who have had a pnumonectomy; where the surgeon may request that it is unclamped for 1min every hour (or what ever their personal preference is).

Clamping chest drains causes pressure changes in the thorax which could lead to a pnumothorax or tension pnumothorax and other complications.

Post cardiac surgery clamping the chest drains can lead to a tamponade.

Sometimes there are special instructions but usually drains should not be clamped.

Hope that helps :)

Some people clamp for transfers which is really dangerous.

Clamping a chest tube will never cause a tamponade, it's just impossible. The thoracic cavity can hold well over the amount of blood circulating in our bodies. Therefore, one could potentially hemorrhage out, but not tamponade.

Clamping a chest tube will never cause a tamponade, it's just impossible. The thoracic cavity can hold well over the amount of blood circulating in our bodies. Therefore, one could potentially hemorrhage out, but not tamponade.

Thats incorrect.

Tamponade is a real issue post-CABG...which is a primary reason why these patients have (usually) 2 mediastinal chest-tubes.

Clamping these tubes immediately post-op can quickly lead to tamponade...as these patients often have elevated PTT's, etc...and can dump a good amount of blood in the first few hours...and an could be an even more pressing issue should the patient have a bleeding/leaky graft..)

Clamping a chest tube will never cause a tamponade, it's just impossible. The thoracic cavity can hold well over the amount of blood circulating in our bodies. Therefore, one could potentially hemorrhage out, but not tamponade.

It seems to me that you might want to read up on cardiac tamponade. The pericardium can not hold well over the amount of blood circulating in the body.

Clamping a chest tube will never cause a tamponade, it's just impossible. The thoracic cavity can hold well over the amount of blood circulating in our bodies. Therefore, one could potentially hemorrhage out, but not tamponade.

What if it's a mediastinal CT?

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