Chest Tube Care
Indication
Remove fluid, air, and blood from pleural cavity
About the chambers
Suction control chamber
When suction is applied by connecting to the wall suction, there should be continuous gentle bubbling in the suction control chamber
Water Seal Chamber
Serves as a one-way valve to prevent air from entering the pleural cavity. When the client breaths, air and fluid exit the pleural cavity and the water seal prevents it from re-entering the pleural space.
Fluid Collection Chambers
Collects drainage from the pleural cavity
How do you know it's working...
- Tidaling in the water seal is normal. Water moves up on inspiration and down on expiration
- There should be no bubbling in the water seal. If bubbling present=air leak.
- Bubbling in the suction control chamber is ok when connected to suction
Nursing Implications
- Tape all connections to prevent disconnections
- Never clamp during transport.
- No vigoroous stripping
- Change chest drainage system when half full.
- Removal critera: 50 ml/day
- Removal critera: no tidaling in the water-seal chamber: Lung has re-expanded.
- Removal critera: chest xray shows problem resolved.
- To remove: client exhales and holds it (Valsalva maneuver) which creates intrathoracic pressure to prevent air from entering pleural cavity. Xray post removal.