Crepitus - page 2

I had this one pt last week and this has been eating at me. The pt had a right sided chest tube. Suction was d/c'd that day and it was to gravity drainage. The tube was sutured in place. He slept... Read More

  1. by   NorthpoleRN
    Thank you for sharing with us! It's been interesting to see how everyone has responded. I hope you don't stress out about this. It's a great learning experience for all of us. I'm glad your facility decided to do and inservice that you found helpful. Keep up the good work!!
  2. by   suzy253
    Thanks for posting your experience and to NRSKaren for the timely references. We sometimes get chest tubes on my floor so I'm going to be doing some reading up on them.
  3. by   Rnandsoccermom
    Quote from Baptized_By_Fire
    I'm with Karen. Have seen crepitus as described several times with chest tubes. Think of it as air trapped under the skin- you have air leaking out, so if it's not self-contained to a small area like in the OP's pt, that's why you put the pt back to suction ASAP. Always palpate edemaous sites, so you can feel for crepitus. You can have crepitus with fractures as well, but it's usually around bursa, skull fx's (think sinuses), or with rib fx's.
    Me too. I have worked on respiratory units for almost 20 years. Seen crepitus in the upper chest, neck many times. It happens, again always remember to palpate edema. Edema in the those areas is never normal, there is always a specific cause.
    Had a few sub-q air pt's in the past, the worst was a 70 something male who was having recurrent pulmonary blebs and pneumos, that required surgical intervention and chest tube sxn. But anyway, this guy developed a leak inside his insertion site and started to swell, we were marking so much on his chest that he looked liked a coloring book.. all the doc's kept putting him off as far as coming in to take a look at him. Swelling from jaw line down to his lt hand, his hand literally look like bad 3rd spacing. Remained stable by respertory/hemmodynamic wise, but was impressive to say the least.
  5. by   bigsyis
    I first saw subcutaneous emphysema (and it was called that) back in 1983. A pt who was dying of lung CA ruptured a bleb. Subq emphysema is not due to a buildup of fluid (I read "edema" in the original post), but the entrance of atmospheric air into the chest cavity.