Question about changing chest tube dsg...

[healthcare4life]

I work on a unit where we don't get many patients with chest tube and was wondering what the steps are for changing (not reinforcing) a chest tube dsg (if for instance it was soiled, etc)

I always worry about pneumothorax with just the thought of taking down the old dressing without quickly slapping on the new one on the site.

Any thoughts would be appreciated.

[Esme12, ASN, BSN, RN]

Follow policy on changing CT drsgs. Call another unit that does them all the time. make sure yoiu ahve an order to change the chest tube drsg. The key is to not pull the Chest tube out while removing the drsg (don't worry the chest tubes are usually sutured in) so slapping on another drsg quickly doesn't matter as long as the chest tube is in place. As long as the system remains intact you aren't going to cause a pneumo....they already have one...hence the chest tube.

This may help......UC Davis Center for Professional Practice of Nursing - Resources - Chest Tube Dressing Change

[amoLucia]

If it makes you feel better, maybe have a second nurse standing by to assist you for the drsg change.

[nurseprnRN, BSN, RN]

Whether the patient has a chest tube in for drainage or for pneumo, it makes no difference. The tube has a suture around it at the subcutaneous level which keeps air from entering the space with spontaneous respiration. You can take that scuzzy dressing off and change it anytime you have to. I wouldn't just reinforce a scuzzy dressing on any invasive tube or line unless that was an explicit part of the medical plan of care-- just think of what's growing in there, just ready to track up the tube. Take that puppy off, clean it up, redress it pretty. Nursing discretion.

If you don't have experience with chest tubes and don't know what's under there, another set of hands to stabilize it until you can see will be reassuring to you.