RNs pulling pleural chest tubes

Specialties CCU

Published

Specializes in Cardiac, respiratory.

In my CCU, we routinely pull mediastinal chest tubes on cardiac surgery patients. Now we have been asked to pull pleural chest tubes. Is there a big difference? If we pull one type, should we be able to pull the other? Can we do so legally? We have a policy for pulling mediastinal only.

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Specializes in Anesthesia.

Acutally pulling the midiastinal CT would make one be more cautious....pleural CT are not an issue whatsoever!

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Specializes in ACNP-BC, Adult Critical Care, Cardiology.

Pleural tube removal is not a benign procedure. Accumulation or recurrence of a pneumothorax is the main concern with chest tube removal. With that said, chest tube removal technique makes a difference in minimizing this risk. As long as RN's are covered by hospital policy with no Board of Nursing restriction on this practice, they can be adequately trained to remove chest tubes.

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

Removing any chest tube ia a practiced skill. I have seen devastating occurrences happen with both. You really need to call your BON and ask them specifically AND be sure you have been adequately trained for this task with a hospital policy in place. Some BON's have specific position statement concerning this practice.....check with them.

http://www.azbn.gov/documents/advisory_opinion/AO%20Chest%20Tubes_%20Removal%20of%20Pleural%20&%20Mediastinal%20Chest%20Tubes.pdf

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Specializes in Cardiac Critical Care.

In our ICU we pull mediastinal and pleural chest tubes. They teach us while orienting in the unit. Only difference is that if we have mediastinal and pleurals, we are to pull the mediastinal chest tubes 1st.

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Specializes in Cardiothoracic ICU.

I pull these too; just ask them to inhale, pull with vasaline dressing and hold pressure for a minute or 2 and place pressure tape.

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Specializes in ICU/CCU/CVICU.

In the ICU I work in we do not pull either. I am actually really surprised to hear that others do. Maybe there is a difference in state practice.

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