Help with chest tube removal questions

[ezther]

Hi everyone, I am hoping to get some feedback about what your personal and local hospital practice is with chest tube removal. If you guys can help with the following questions that would be greatly appreciated!

1. What is your training background?
   
2. Where do you work?
   
3. How much experience do you have with pulling chest tubes (how often and for how long)?
   
4. How do you currently pull your chest tube now?
   
5. Do you do this on your own or with an assistant?
   
6. Have you experienced air re-entering the pleural space and the need for re-inserting a new chest tube?
   
7. Is there anything about pulling chest tubes that you think can be improved?
   
8. If there is a tool that makes pulling chest tube easier and safer, what features are important in order for you to adopt it?
   

[Sour Lemon]

I've never worked at a place where nurses remove them.

[ezther]

Where do you work if I may ask? I work in Canada and only nurses who are trained to do the procedure (typically those in ICU or thoracic floor) are allowed to removed them.

[AceOfHearts<3]

I'm in the USA. On my tele unit someone from IR (interventional radiology), normally the NP or PA, tends to remove them. I've assisted- helping with supplies, bandaging, etc.

[AliNajaCat]

I've never worked anyplace where RNs remove chest tubes-- it's usually the low-man-on-the-totem-pole R1s. God knows I've talked enough of them through it, though.

[Sour Lemon]

Where do you work if I may ask? I work in Canada and only nurses who are trained to do the procedure (typically those in ICU or thoracic floor) are allowed to removed them.

I have only worked at three hospitals in two different states, but the MD has always been the one to remove chest tubes in any department. Personally, I've only worked in med/surg, psych, and as a tele float on occasion.

[Rose_Queen, BSN, MSN, RN]

I've pulled chest tubes, usually just prior to surgical prep and when the patient is anesthetized with only the non-affected lung being ventilated. Surgeon is in the room already or right outside scrubbing, immediately available, but we also tend not to be too concerned about a lot of air because we're going to be cutting the chest open anyway. Other than that, the only people who pull chest tubes are trauma or cardiothoracic surgeons, PAs, or NPs. No residents here.

[sallyrnrrt, ADN, RN]

I have pulled them for over 4 decades without complication, but I may just be old school educated