Published May 3, 2004
Has anyone ever irrigated a chest tube in pts. with empyema? If so what are the risks and/or complications?
Burnt Out, ASN, RN
i have never irrigated a chest tube...i don't think that is in my scope of practice. now our surgeons will instill a sterile talc like substance for people with severe pleural effusions that are not draining/resolving as expected.
We had a patient recently with empyema and had to irrigate her chest tube twice a day with one half saline and peroxide??? Ever heard of that?
Never had to do it but have helped Radiologist place many chest drains and it makes sense that if the empyema is particularly thick/purulent, you'd want it thinned out and also to keep the tubing/drain from becoming blocked w/crud (nursing term!). The chest drain is not in the lung itself, probably just in the fluid collection, so if you irrigate, you don't push fluid into the lung - just into the space that the fluid collection has created by its presence.
BTW, placement of chest drains is usually done guided by CT scan, so the Radiologist "sees" exactly where he's placing the tube = no guesswork! You do know you're in position, too, when the fluid (pus) starts rolling out ! We'd also confirm placement, too, by doing a few CT scan "cuts" throught the affected area, and also by post-placement CXR.
There's always something more to learn, eh?
Take care -- D
RNPATL, DNP, RN
No we have never had to irrigate a chest tube. Have had several with empyema, and know that the surgeons will do it. We have done a lot of talc pleurodesis (sp) for unresolved pneumos.
Just sat on a commitee at work cuz they want us to start this. None of us are comfortable but interventional radiology is always on hand to help. Its not a chest tube per se that we irrigate, there is a small catheter that is put in the pleural space with a stop cock attaches. You put in a small amt of saline and GENTLY aspirate out. If I have ANY questions, I'm on the phone with IR and they come up to do it.
Hi im juist a newbie here am quite interested with ur question. Im just a newly grad nurse still in the philippines. Am still adjusting to the routines in the med surg ward. And am stil quite confused if I do want to be in. The supervisor says that our ward is the most toxic ward in our institution. But its a very good training ground she said. Is med surg still in demand in US or UK? But she promised me that as soon as there's a vacancy in icu she'll train me asap. Everybody who are placed in that area are changing their minds alreay and transferring to other units. As for me I still don't know am still confused.Hope u can help me.
Med-surg can be and often is the toughest job you will ever love to hate! It can be rewarding and it also can challenge every skill you have or don't have, but rest assured, if you give your all to the med-surg unit, in return, you will have learned skills and clinical experience that will follow you throughout the rest of your career.
There are a number of threads located under this forum dedicated to the medical & surgical nurse. Take a moment to read some of them. Here are a few links that you might find helpful.
https://allnurses.com/forums/showpost.php?p=861195&postcount=1 - advice for new nurses entering med-surg.
https://allnurses.com/forums/showpost.php?p=870443&postcount=1 - med-surg a new nurses right of passage.
Hope these help and welcome to our forum. Hope you stay and enjoy for a while.
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