Insertion of chest tubes location

[Anchoredsoul03]

Hey all,

I'm doing an assignment for lab and can't find the info in my text or anywhere online, if you know the answer I would appreciate your help:

Q is True or False- Chest tube placement for draining a hemothorax is placed between the 4th and 6th intercostal space at the midaxilary line

and

Q The two bottle water seal system utilizes the first bottle to collect drainage and the second as a water seal True or False?

Thanks!!! :redpinkhe

[Daytonite, BSN, RN]

true or false- chest tube placement for draining a hemothorax is placed between the 4th and 6th intercostal space at the midaxilary line

this is because the fluid settles by gravity to these lower levels of the intrapleural spaces. the purpose of the chest tube when there is a hemothorax is to drain the blood. (page 118-119,

nurse's 5-minute clinical consult: procedures

from lippincott williams & wilkins). i initially answered this false since if the patient is bedridden gravity is going to move the blood to the posterior areas of the patient's chest cavity. however, my references here at home do state the tube is inserted anteriorly and the patient should be encouraged to lean over the overbed table or straddle the back of a chair. the fact is that the placement of chest tubes is often a physician preference based on their experience and success.

the two bottle water seal system utilizes the first bottle to collect drainage and the second as a water seal true or false?

the collection chamber is always the very first one between the system and the patient. it catches and traps any drainage coming out of the chest cavity while allowing the any air escaping from the chest tube to continue on to the water seal chamber. the water seal bottle, or chamber, will be the farthest one in the series of chambers between the patient's chest and the final water seal chamber. it allows any air escaping from the patient's chest to escape into the atmosphere while maintaining the negative pressure of the chest cavity.

http://www.icufaqs.org/chesttubes.doc

[Anchoredsoul03]

Thanks so much Daytonite! I appreciate the link also. I definitely have a better understanding of the chest tube drainage system now.

[mcknis]

Since I see you are new to this site, let me jsut say welcome, but secondly...Daytonite is very knowledgeable and you will find she is very helpful for explaining theories!