Chest tube nursing [Adult Nursing Practice]

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1. Sealed thoracic drainage

Sealed thoracic drainage uses a water-sealed drainage device to remove abnormal air, blood, and inflammatory exudates from the pleural cavity. The chest tube is usually inserted during surgery, and two chest tubes are typically inserted after lobectomy to remove air from the pleural cavity. The chest tube is inserted along the posterior axillary line in the 7-8th or 8-9th intercostal space to remove serous fluid accumulated in the lower part of the pleural cavity.
2. Sealed thoracic drainage device

The sealed thoracic drainage device consists of a drainage bottle, a sealing bottle, and a suction pressure control bottle. The long transparent tube of the sealing bottle is submerged 2cm in water, acting as a one-way valve to allow air from the drainage bottle to move to the sealing bottle but not vice versa. The air moved from the drainage bottle to the sealing bottle then goes to the suction pressure control bottle. If there is a pneumothorax, bubbles will form in the sealing bottle. The other short tube in the suction pressure control bottle is connected to the suction device, and the long tube submerged in water allows air from the atmosphere to enter, maintaining a constant suction pressure of 10-20cmH2O.
3. Nursing care for sealed thoracic drainage

1) The drainage device should be placed lower than the patient's chest to prevent backflow. 2) The patient should be in a semi-Fowler's position, and the tube should not be compressed or kinked during position changes. 3) The length of the connecting tube should be appropriate for the patient's position to prevent kinking. 4) The chest tube should be kept open, but forceful suctioning that can increase the intrathoracic pressure up to 400cmH2O and cause lung injury should be avoided. 5) The drainage system must be completely airtight. 6) The suction pressure is usually maintained at 10-20cmH2O. 7) The function of the sealed thoracic drainage should be observed by monitoring the water oscillation in the sealing bottle, which reflects the patient's ventilation. 8) The drainage volume should be measured. 9) The drainage bottle should be regularly replaced with a sterilized one. 10) Clamps should be available to quickly clamp the chest tube in case of emergencies. 11) Infection prevention, coughing, deep breathing, and daily activities should be encouraged. 12) The chest tube is removed 2-3 days after surgery or when the air leakage stops and the drainage is less than 60ml per day.
4. Chest tube drainage

The purpose of chest tube drainage is to normalize the intrathoracic pressure by removing abnormal air or fluid from the pleural cavity and allowing the lung to re-expand. The one-bottle system is used for air drainage, the two-bottle system is used for draining air and fluid, and the three-bottle system is used to maintain a constant suction pressure. Nursing care includes maintaining the drainage system below the chest level, adding sterile water to prevent evaporation, observing the water oscillation in the sealing bottle, managing air leaks, and encouraging the patient's respiratory exercises. The chest tube is removed when the lung is fully re-expanded and the drainage is minimal.

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1. Sealed thoracic drainage

Sealed thoracic drainage is an essential medical procedure used to remove air, blood, or other fluids from the pleural space surrounding the lungs. This technique helps to restore normal lung function and prevent complications such as pneumothorax or hemothorax. The sealed drainage system ensures that the negative pressure within the pleural space is maintained, allowing for proper lung expansion and preventing the entry of air or other contaminants. Proper management of the sealed thoracic drainage system is crucial to ensure patient safety and promote healing. Nurses play a vital role in monitoring the drainage system, assessing the patient's condition, and providing appropriate interventions to address any issues that may arise. Continuous education and training for healthcare professionals on the proper techniques and protocols for sealed thoracic drainage is essential to ensure optimal patient outcomes.
2. Sealed thoracic drainage device

The sealed thoracic drainage device is a critical component in the management of patients with various thoracic conditions, such as pneumothorax, pleural effusions, and post-operative air leaks. These devices are designed to maintain a negative pressure within the pleural space, allowing for the controlled drainage of air, blood, or other fluids, while preventing the entry of air or contaminants. The device typically consists of a collection chamber, a one-way valve, and a water seal, which work together to create and maintain the necessary negative pressure. The selection of the appropriate drainage device and its proper setup and management are crucial to ensure patient safety and promote healing. Healthcare professionals, particularly nurses, must be well-versed in the use and maintenance of these devices to provide high-quality, evidence-based care. Ongoing research and development in this field can lead to further improvements in the design and functionality of sealed thoracic drainage devices, ultimately enhancing patient outcomes.
3. Nursing care for sealed thoracic drainage

Nursing care for patients with sealed thoracic drainage is a critical component of their overall management. Nurses play a vital role in monitoring the drainage system, assessing the patient's condition, and providing appropriate interventions to address any issues that may arise. This includes regularly checking the drainage system for any leaks, ensuring the proper functioning of the one-way valve and water seal, and monitoring the drainage output for any changes in color, consistency, or volume. Nurses must also be vigilant in assessing the patient's respiratory status, vital signs, and overall comfort level, and promptly reporting any concerns to the healthcare team. Additionally, nurses are responsible for educating patients and their families on the importance of the sealed thoracic drainage system, proper care and maintenance, and signs and symptoms that may require immediate attention. Ongoing training and education for nurses on the latest evidence-based practices in the management of sealed thoracic drainage is essential to ensure the delivery of high-quality, patient-centered care.
4. Chest tube drainage

Chest tube drainage is a critical medical intervention used to remove air, blood, or other fluids from the pleural space surrounding the lungs. This procedure is often necessary in the management of various thoracic conditions, such as pneumothorax, pleural effusions, and post-operative air leaks. The proper placement and management of the chest tube, as well as the associated drainage system, are crucial to ensure patient safety and promote healing. Nurses play a vital role in the care of patients with chest tube drainage, as they are responsible for monitoring the drainage system, assessing the patient's condition, and providing appropriate interventions to address any issues that may arise. This includes regularly checking the drainage system for any leaks, ensuring the proper functioning of the one-way valve and water seal, and monitoring the drainage output for any changes in color, consistency, or volume. Nurses must also be vigilant in assessing the patient's respiratory status, vital signs, and overall comfort level, and promptly reporting any concerns to the healthcare team. Ongoing education and training for nurses on the latest evidence-based practices in the management of chest tube drainage is essential to ensure the delivery of high-quality, patient-centered care.

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