Irrigating a chest tube...

Specialties Critical

Published

Specializes in LTC, New to Tele/ Cardiac!.

Hi all. Okay so I worked last night and had a pt with 2 posterior chest tubes pigtailed to the pleurevac with the small catheters that have the stopcock mechanism. I was told in report that we "flush the chest tube and then aspirate slowly for output." I have heard of irrigating chest tubes but I just wasn't sure so I even had the day nurse show me before she left. Sure enough there was an order to "flush chest tubes with 10 cc sterile ns qs and record output". I used a 10 cc syringe with sterile ns and utilizing the stopcock i flushed then slowly aspirated contents. i got 2 cc return out on the left and 24 cc on the right (it just kept coming! eek!). pt was stable, no complaints, breathing at ease. so this AM after report, the nurse getting my report is like, "umm is there an order to ASPIRATE?! I've never heard of that. That's scary". I'm a new nurse to this floor. I've only been working on this unit for 6 months. The day nurses are not always the nicest people. So I started to get nervous thinking that I did the wrong thing! Maybe I was just supposed to irrigate and not "record output"? But the prior nurses to me were doing this procedure as well and recording it in their nurses notes.. I just don't want to get in trouble or reported and I'm doubting myself!!! Has anyone ever heard of this type of order? I've been searching everywhere and really can't find too much on this issue. I really hope I didn't screw up :crying2: Thanks.

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Specializes in ICU.

Open the chart and 'read the order'. Hopefully, that would clear up any questions (and not create more!). Was the pleuravac to suction or simply 'water seal'?

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Specializes in LTC, New to Tele/ Cardiac!.

In the chart it said "flush ct with 10 cc sterile ns. don't remove fluid too quickly" (poorly written md order). and yes, the pleuravac was to suction -20 cm.... I have since been to work and no reprocussions occurred on my end. the pt was transferred to a medsurg unit so im guessing his condition improved... i was just curious! i guess next time ill just have to call the md and clarify/verify the order (gotta love calling a surgeon on 3rd shift. haha!)

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Specializes in General 9yrs; Ortho-2y Intensive Care-6y.

yeah, just clarify the order with the md next time.

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Specializes in Trauma/Critical Care.

hi kaitrn,

according to kinkwood (a cardiovascular anp)" practices such as suctioning and/or irrigating chest tubes to free blood clots, either pleural or mediastinal, are described in the literature. even though there is no research to support this practice, munnell7 states that irrigation of a chest catheter or drainage tube occasionally must bed one if blockage from a blood clot is suspected or when performing pleurodesis. however, because of the possibility of infection being introduced because of repeated opening of a sterile system, this practice should be discouraged"

at my facility, the policy is to let it drain and measure...we do not aspirate. as you mentioned, in the future, be safe and clarify with the md.:)

reference:

kinwood, p. (2002) critical care nursing.22: 70-72 . retrieved from

http://ccn.aacnjournals.org/content/22/4/70.full

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I like your APA formatted reference :smokin:

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