Throidectomy JP connected to wall suction? Should bulb be charged?

[DutchgirlRN, ASN, RN]

I had a fresh thyroidectomy today. The doctor ordered the JP to be hooked to continuous medium wall suction. I had seen this before. I cut the top off of the spout where you normally empty the JP, cut the connector off of the suction tubing and hooked it to the spout. Perfect fit. The only thing was that the bulb was staying charged. In the past I thought I remembered the bulb staying inflated? But if it was inflated would it still pull blood out of the wound? Would it not have to be charged in order to create that suction? However with it being charged it won't pull into the suction tubing and up to the canister. Is anyone more familiar with this procedure? Do you know should the bulb be inflated or charged? Thanks!

[meownsmile, BSN, RN]

There may be a clot in the JP drain in the incision. Once the clot has been pulled through you may find it is expanded again. But im not sure of why you cut the cap off the bulb. Really no reason to because it can be kept clean by a alcohol prep enveolpe and a little tape. Then when suction is removed you have a intact JP that can still be used to evacuate the incision. The ones we have are usually taken off suction after the drainage is reduced. But now you have nothing to close the JP bulb when it is removed from suction.

[Tweety, BSN, RN]

By "charged" are you meaning compressed and deflated? I'm not familiar with that term.

I've seen that set up a couple of times and the suction usually deflates or compresses the bulb. I would think this is the way it should be, as it's the maximum suction. If the JP was open and inflated with air, I would indicate that there was a leak of sorts somewhere.

[RNPATL, DNP, RN]

By "charged" are you meaning compressed and deflated? I'm not familiar with that term.

I've seen that set up a couple of times and the suction usually deflates or compresses the bulb. I would think this is the way it should be, as it's the maximum suction. If the JP was open and inflated with air, I would indicate that there was a leak of sorts somewhere.

The times that I have placed JP to wall suction, the bulp actually was deflated with the suction intact.

[DutchgirlRN, ASN, RN]

There may be a clot in the JP drain in the incision. Once the clot has been pulled through you may find it is expanded again. But im not sure of why you cut the cap off the bulb. Really no reason to because it can be kept clean by a alcohol prep enveolpe and a little tape. Then when suction is removed you have a intact JP that can still be used to evacuate the incision. The ones we have are usually taken off suction after the drainage is reduced. But now you have nothing to close the JP bulb when it is removed from suction.

The doctor told me to cut the cap off of the bulb before connecting it to the suction tubing. Just following the doctors orders! This occured just before the shift ended. I milked the tubing as directed. He ordered the tubing to be milked Q 1/hr. I'm assuming that if there was clot that during the night it would be milked/suctioned out and the bulb would re-inflate?

It makes no sense to me that the bulb would stay inflated and not compressed with the suction on continuous because that is how JP's work but I clearly remember seeing this situation before and remembering the bulb not being compressed. I will have to ask the doctor to explain it to me the next time I see him. I'll let you know.

[DutchgirlRN, ASN, RN]

I got another fresh thyroidectomy yesterday and I asked the doc about hooking the JP up to suction and he said the bulb should stay charged (compressed) if it is inflated that means there's a clot somewhere and the tubing needs to be milked. I'm so glad that's cleared up!