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Clamped Chest Tubes

Hospice   (2,971 Views | 4 Replies)
by tplazio tplazio (New) New

571 Profile Views; 1 Post

Is anyone familiar with a palliative chest tube? I have encountered one once when I worked as the RN at a personal care home and now that i manage education for multple skilled facilities I'm hearing more and more case. These tubes are not attached to anything. When the MD orders you unclamp, connect a syringe and withdraw fluid/blood. My experience was new for me and the hospice nurse. We kind of muddled through it together. We kept a clean, dry dressing. Lung sounds and vital signs. To put something together to help these other nurses I was hoping someone has had more experience and can give me some guidance. The only other time I've clamped a chest tube was after I administered chemo into it and clamped it for several hours and then drained it. Any help is much appreciated. Thanks

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curiousauntie has 26 years experience and specializes in LTC, Sub-Acute, Hopsice.

167 Posts; 4,487 Profile Views

I've dealt with patients with tubes that are attached to a vacuum bottle ( it looks like a bowling pin) that are used for malignant pleural effusions and acities. My patient needed draining every three or four days until the last couple of weeks of his life when I was draining almost every day for comfort. When he needed to be drained he was almost unable to breathe, but due to adhesions it was painful, even with pre-meds, so he tended to put it off "just one more day".

For the life of me I can't remember the name of the system...if I could I would tell you that the company that makes it has a web site for training of both the medical personal (you can watch a video of how to put the tube in) and for the patient or caregiver who will be draining it. The dressing procedure was pretty individualized for the product to keep the tube outside of the body secure to the body and protected from infection.

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ErinS is a BSN, RN and specializes in Hospice.

347 Posts; 5,457 Profile Views

We use aspira drains. They can be placed anywhere fluid needs to be drained, so we occasionally see chest tubes, but usually we see them for ascites drainage. They have this nifty port that you connect a bag system to, and then there is a squeeze pump that will get fluid going, and then a bag for it to drain into. The best part is it is so easy to use that we often teach caregivers how to use it.

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13 Posts; 1,145 Profile Views

We see this fairly often and use the pleurovac system. If memory serves me right, that is actually the trade name. They have a cd for the family and I think the video is also online. The tube is clamped aftet insertion and dressed. We drain it according to orders and patients status. Sometimes it is evety other day, sometimes once a week. Our drainage bottlecomes in a 500 cc size although pts have been sent supplies with a arger bottle, too. Our docs usually dont want more than 450 ccs drained per session.Drainage is painful at times but not always. If you keep your hand on the clamp so you can slow itdownor stop if the patient looks like he is in pain, it is reassuring for the pt. They know we can stop a rest a bit, if need be. I usually call when imheaded to the home so he can take a pain pill, if pain is a problem.After draining, we clamp the tube. A new clamp and dressing pack comes with each bpttle. Dress it and you're done. Not nearly as intimidating as I expected it to be at first. I will see if i can find the website for the company and post it for you.

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13 Posts; 1,145 Profile Views

Pleurx is the brand name for the system we use. I tried to attach the link but my ipad is not cooperating. Sorry. But if you google it you shouldnt have trouble finding it. I thought there was an instructional video on the site, but i guess i saw it on the CD that comes with the family education pack.

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