How do you flush a JP drain???

[Katie_Bell]

I work on a surgical floor, and have for about a year, but I've yet to have to flush a JP drain. I overheard one of my coworkers talking about having an order to do so, but I was unable to follow up and ask her HOW.

It sounds like the drain comes from the wound site, then there are 2 ports -- 1 that is hooked up to tubing and goes to the JP bulb, and the other just an available port.

How exactly do you flush a JP, especially given that it has 2 ports as opposed to 1? I have absolutely no idea. Where do you hook up the saline syringe too? Which port? I know nothing!

If anyone can offer advice based on their experience, that would be great!

[meownsmile, BSN, RN]

Not that it isnt done with certain types of things, but in 14 years i have never had to nor seen a JP drain flushed/irrigated. Those drains are usually put in to drain operative fluids used to irrigate or to drain serrous fluids from the wound not for irrigation following surgery.

We did recently have an abdominal wound that the dr had put NG tubes into the wound and hooked up to IV bottles and connected to suction but that was a whole different thing. Like i said i guess it is possible to use the JP drain that way, but i havent ever seen it.

[Jay-Jay, RN]

Personally, I don't like the idea, and have never done it. The risk in my eyes, is that it's not a closed system. You are flushing debris that has been exposed to room air back into the wound!!

I have dealt with thousands of JP's as a community RN, and the best way to keep JP's from blocking up is to have the patient strip the tubing every couple of hours. It's flexible, so they can grab it between their fingers, and milk it in the direction of the bulb.

Now, hemovacs...whole different story! I hate hemovacs. You cannot strip the tubing, and they are very prone to air leaks. I have had to detach the vac from the tubing to clear blood clots. Often when you do this, a long, stringy blood clot will be sticking out of the drain. If you can grab hold of the clot with a sterile piece of gauze, often you can clear the drain by gently pulling it out. Now, the nexty problem is re-attaching the drain so that the system will still keep suction. Good luck!

[Fiona59]

Have seen that order twice in the last two months. The tube coming out of the body has a little lever thing that rotates to lock or open and then the tube connects to the bulb. You fit the saline syringe to the port and make if I recall right you lock it so that the flush goes into the body and not the bulb.

Sorry for the cruddy description but its one of those things that you need to see done...

[Jay-Jay, RN]

Ah, okay this is something new to me. Our JP's aren't like that. The tube comes directly from the body into the bulb, with nowhere you can disconnect it without causing a possible air leak.

[P_RN, ADN, RN]

Next time you see one, will you look at the op note and see what it's called? I know JP makes more than one style of drain, but I don't think any of them have a proviso for irrigation.

[dazey71]

I've seen 2 different types of JP drains on our unit. I've only had the order to flush a JP twice, and the hook-ups were different. On the ones that needed to be flushed and aspirated, there was a sort of screw we could use. Most of the time we just strip the drains, though.

[porterwoman]

I did this one time--but not seeing it in front of me, it's hard to describe.

I think I disconnected below the stopcock, screwed the 10 cc syringe onto the tubing, flushed, then I somehow had to screw the tubing back together while the instilled saline was trying to flow back out. Didn't seem very sterile to me. One of the nurses who'd taken care of the pt showed me how.

Has someone else been able to clarify how to do this?

[cdmadere]

wow...I have never seen this type of JP drain.

[Fiona59]

There isn't alot of markings on the attachments. Don't even remember seeing a brand name. I've seen both where you flush into a port type device and the one where the tube comes away from the port to gain acess to the port.

But you flush and aspirate back into the syringe.

[Arkend]

The type of drains used at the hospital where I work are called Van Sonnenberg drains. They must be flushed once every 8 hours with 10ml NS (if ordered by MD). As they are placed for abscess drainage, the fluid is often yucky. The tubing has a port and stopcock we do not have to disconnect anything.

[gitterbug]

Never seen this new type of drain. Never flushed a JP either. If drainage was slow, we were ordered to milk the tubing gently q 4 hours. Worked well with no trauma to patient.