Help with chest tubes

[Student0911]

Level 4 and Graduating in May 2011! :mnnnrsngrk:

Studying chest tubes and need some assistance on answering a question in my learning guide.

Q:Should a leak be detected what signs and symptoms might the client show?

My guess is returning symptoms of Hemo or Pneumothorax

i.e. Dyspnea, diminished breath sounds, decreased movement of chest wall

Any help would be appreciated. Thanks.

[SlyckRN]

IF there is a leak in your chest tube you have lost pressure. Depending on if you are on a water or waterless system. You won't see the bubbles in the sterile water, or you won't see the flucuation in the tubes either. Both mean that you have lost pressure.

[MunoRN, RN]

A leak in a CT system she first be localized the source since it may somewhere in the system outside of the patient, this is done by pinching the chest tube distal to the patient and then moving closer to the patient until the point of entry (if the patient should become short of breath while pinching, then stop pinching). If the air leak disappears while pinching the tubing, then the leak is somewhere between that point and the Atrium (or whatever system you use). The air leak may also be in the dressing, so you can try reinforcing the dressing if allowed to.

If it is a true patient air leak, then having the CT in should prevent dyspnea due to a pneumo. This why we often only pull pleural CT's after clamping it then getting a CXR, to confirm that there isn't an asymptomatic pneumo when the CT is not there to prevent it.

The most common sign is usually SQ crepitus (feels like rice krispies under the skin), usually above the site and sometimes settles in the armpit area or neck.

[ImThatGuy, BSN, RN]

I want to do a chest tube. I should've been a doctor, lol.