Chest Tube Drainage System Setup
Chest tube drainage uses gravity and, possibly, suction to restore negative pressure and remove material that collects in the pleural cavity. The disposable drainage system combines drainage collection, a wet or dry seal, and suction control. The seal in the drainage system allows air and fluid to escape from the pleural cavity but doesn’t allow air to reenter. Patient safety features on the device include a pressure relief valve and an air-leak indicator. There are three types of chest tube drainage systems: a water-seal–wet suction system, a water-seal–dry suction system, and a dry seal–dry suction system.
Chest tube drainage may be ordered to remove accumulated air, fluids (blood, pus, chyle, and serous fluids), or solids (blood clots) from the pleural cavity; to restore negative pressure in the pleural cavity; or to reexpand a partially or totally collapsed lung.
Equipment
Single-use, disposable, sterile chest drainage collection unit (water-seal–wet suction system, water-seal–dry suction system, or dry seal–dry suction system) ▪ sterile water ▪ gloves ▪ suction source ▪ wall-mounted or portable suction-control device ▪ suction connection tubing ▪ chest tube clamp (one per chest tube placed).
Implementation
Check the doctor’s order to determine the type of drainage system to be used and other procedural details.
Gather the necessary supplies.
Confirm the patient’s identity using at least two patient identifiers according to your facility’s policy.1
Explain the procedure to the patient.
Maintain sterile technique throughout the procedure and whenever you make changes in the system or alter the connections to avoid introducing pathogens into the pleural space.
Open the single-use sterile chest drainage unit. Use the floor stand to set the unit on the floor or use the hangers to hang it level on the bed.
Water-Seal–Wet Suction System
Use sterile water to fill the water-seal chamber to the specified level according to the manufacturer’s instructions. The water-seal chamber acts as a one-way valve to allow air to pass out of the lung, down through a narrow channel, and bubble out through the bottom of the water seal.
Fill the suction-control chamber with sterile water or normal saline solution to the prescribed level (usually −10 to −20 cm of water).
Connect the patient’s chest tube to the chest tube drainage system.
Connect the suction tubing to the drainage system and the suction regulator (as shown below). Adjust the suction until gentle bubbling appears in the suction-control chamber. The addition of suction increases the negative intrapleural pressure and helps overcome air leakage by improving the rate of airflow out of the patient and improving fluid removal.
Stay updated, free articles. Join our Telegram channel
Full access? Get Clinical Tree
