Post by annelieseRN on Mar 18, 2012 6:19:22 GMT -5
There are four common conditions than can require surgical chest tube insertion, including:
* pneumothorax (air leak from the lung into the chest)
* hemothorax (bleeding into the chest)
* empyema (lung abscess or pus in the chest)
* pneumothorax or hemothorax after surgery or from trauma to the chest
The chest tube can be removed when one of the following has happened:
* The lung has fully expanded.
* No air leak has developed during a 248 hour period.
* Less than 5.07 oz (150 ml) of fluid has drained in a 24- hour period.
The nature of the materal draining from the tube is also important. If it is blood, the chances of requiring a thoracotomy are much higher if the blood is bright red and arterial rather than the dark red of venous blood. Drainage of intestinal contents implies either an oesophageal injury or stomach / bowel injury with diaphragmatic tear. A persistent air leak implies an underlying lung laceration, and large leaks may indicate bronchial disruption.
TYPES of drainage systems:
* Open or closed:
o Open drains (Including corrugated rubber or plastic sheets) drain fluid on to a gauze pad or into a stoma bag. They are likely to increase the risk of infection.
o Closed drains are formed by tubes draining into a bag or bottle. Examples include chest, abdominal and orthopaedic drains. Generally, the risk of infection is reduced.
* Active or passive:
o Active drains are maintained under suction (which may be low or high pressure).
o Passive drains have no suction and work according to the differential pressure between body cavities and the exterior.
* Silastic or rubber:
o Silastic drains are relatively inert and induce minimal tissue reaction.
o Red rubber drains can induce an intense tissue reaction, sometimes allowing a tract to form (this may be considered useful - for example, with biliary T-tubes).
* pneumothorax (air leak from the lung into the chest)
* hemothorax (bleeding into the chest)
* empyema (lung abscess or pus in the chest)
* pneumothorax or hemothorax after surgery or from trauma to the chest
The chest tube can be removed when one of the following has happened:
* The lung has fully expanded.
* No air leak has developed during a 248 hour period.
* Less than 5.07 oz (150 ml) of fluid has drained in a 24- hour period.
The nature of the materal draining from the tube is also important. If it is blood, the chances of requiring a thoracotomy are much higher if the blood is bright red and arterial rather than the dark red of venous blood. Drainage of intestinal contents implies either an oesophageal injury or stomach / bowel injury with diaphragmatic tear. A persistent air leak implies an underlying lung laceration, and large leaks may indicate bronchial disruption.
TYPES of drainage systems:
* Open or closed:
o Open drains (Including corrugated rubber or plastic sheets) drain fluid on to a gauze pad or into a stoma bag. They are likely to increase the risk of infection.
o Closed drains are formed by tubes draining into a bag or bottle. Examples include chest, abdominal and orthopaedic drains. Generally, the risk of infection is reduced.
* Active or passive:
o Active drains are maintained under suction (which may be low or high pressure).
o Passive drains have no suction and work according to the differential pressure between body cavities and the exterior.
* Silastic or rubber:
o Silastic drains are relatively inert and induce minimal tissue reaction.
o Red rubber drains can induce an intense tissue reaction, sometimes allowing a tract to form (this may be considered useful - for example, with biliary T-tubes).