Question about Jackson Pratt Drains & retention sutures - page 3

How many of you have ever removed Jackson Pratt drains? If you have never removed them yourself, but have watched them be removed, you would feel comfortable doing it on your own? I would esp like... Read More

  1. by   Burnie
    Hi! I am new to this site and have been reading some interesting comments, stories. I have removed jp drains by order of the physician on several occasions during my career. However, on a personal note - let me warn you to be very careful and examine the tube before you attempt to remove it. I underwent surgery last March and when the DR went to remove my jp drain, the drain broke into two pieces and recoiled back into my wound. I had to have surgery, again, to remove the tube and of course, I'm a nurse, so I have had multiple complications and infections due to it.
    Be very careful. I will never again remove one. I had not heard of a tube breaking before it happened to me and since then, I have heard a few stories. Your best bet is to NOT remove it. The dr. placed it, let him remove it.
  2. by   orrnlori
    I work in surgery. Just to let you all know, retention sutures are never part of the wound suture. They are placed separately, usually with silk or nylon suture. Also, most doctors cut the JP between the holes, not through the holes, sort of a way to make sure the drain doesn't break at the holes and accidently leave the tail of the drain in the wound, if you look at the end of the drain, you should see a clean cut. Hope this helps.
  3. by   RNinRubySlippers
    I have pulled a JP drain and I am a nursing student. It is a skill we learn at the beginning of 3rd semester. The suture was the haredest part as it is very tight and hard to pull up so you can cut it. The drain is very long and that was surprising, even tho i knew it was. Doing it is completely different! I think it hurt the pt. more than me tho...but I felt terrible doing it...I am sure you know what I mean!
  4. by   fiestynurse
    JP drain always removed by doctor. I was never asked to remove one.
  5. by   mackrn
    I have removed JP, hemovacs and just about every type of drain that you can think of patients having inserted. Of course have been a trauma/ortho nurse off and on for over 25 years and have been in hyperbarics and wound care for the last 15 years. Piece of cake actually and sometimes a lot easier than waiting around for physican to show up.
    Have removed some retention sutures, but usually when placing a negative pressure dressing on the wound and they are in the way of getting a good seal over the dressing.
  6. by   wessie17
    can i ask something?

    For the JP, what's the normal amount that should be drained? Because for example, a post operative patient after 4 hours had 10 ml drain output then after 45 minutes, the output suddenly increased to 75 ml.
  7. by   OgopogoLPN
    I'm an LPN in BC and I have removed JPs and hemovacs. I can also be the 2nd nurse in a chest tube removal.
  8. by   POTR
    Quote from wessie17
    can i ask something?

    For the JP, what's the normal amount that should be drained? Because for example, a post operative patient after 4 hours had 10 ml drain output then after 45 minutes, the output suddenly increased to 75 ml.
    There are so many variables involved there that this question is unanswerable. Ask your Charge what they think, and no matter what they think, if it still concerns you after to talk it over with them, call the Doctor.
  9. by   wessie17
    well, this a case study and we just have to know what the normal amount is. what we know is 50 ml. since the patient had 75 ml all of a sudden...meaning it's abnormal.
  10. by   LeaRN627
    I have been a surgical RN for 36 years and have practiced in GA, NJ, SC, CA, TX, NE, and CT. I have always removed various drains and tubes and retention sutures. All of those places had policies in place. However, I think you were right to question and should not have been criticized in front of others or made to feel as you were for questioning. It is a smart nurse who questions when in doubt and if you are uncomfortable with an unfamiliar procedure it is the responsibility of the supervisor to get you training. That being said, I also would not condone telling the patient you were not familiar if nurses can do that procedure. You have now compromised the nurse who is familiar with that technique, but now the patient will be fearful of allowing a nurse to do any procedure. I would suggest that you simply tell the patient you need to check on the order before proceeding, then contact your supervisor and tell him/her that you have not done this and you are not clear if this is an allowed RN task. You have every right to refuse to do a skill set you have not been properly trained in, but you should be careful to not undermine the skills of nurses in general when the doubt may simply be in your mind, not in other nurses already skilled in this technique. Once a patient hears you say you are not sure about something, the patient is going to be wary of all the nurses in your agency. Just my humble opinion. Good job of seeking answers and poo to your supervisor for making you feel bad asking questions!
  11. by   cherrybreeze
    I am honestly surprised by the number of people who've responded by saying that the surgeon is the only one that removes drains.

    The RN's in my facility remove drains (we mostly see JP's, but some hemovacs, etc). That's been how it is as long as I've been there (9+ years). A couple of the surgeons will CHOOSE to remove their own, but they do not have to. I saw someone mention that CRNA's remove epidurals; RN's do that in my hospital, fact, we used to have to be "checked off" by an anesthesiologist to do it, now an RN that has been trained can check off another RN to do it.
  12. by   meaniegreen
    This post was really interesting b/c just today I rec'd an order to d/c a JP and since I've never done that in 28 yrs, including ICU settings way back, I asked the other coordinators I work with who all said no except one sort of hot shot. So I asked one of my surgeons who kindly went with me, showed me exactly what to do, AND what to watch for to indicate a fracture of the drain internally. Later I emailed our nursing exec supervisor who said that we are allowed to do that. How can we be nurses and not be clear on these details???!!!!
  13. by   CoffeeRTC
    Yeah, an old topic, but we have been getting patients with these in our LTC. Yes, we remove the drains.