CARE OF CHEST DRAINAGE

DEFINITION

• Inter costal water seal drainage system is insertion of tubes into the pleural cavity with attached drainage system so as to remove air , blood or fluid from the pleural cavity

CARE OF THE CLIENT WITH CHEST TUBE DRAINAGE

• Assess the client after doing the hand wash :

a) Pulmonary status

b) Vital signs

c) Pain

• Observe :

a) Chest tube dressings & site surrounding tube insertion

b) Tubing for kinks, dependent loops or clots

c) Drainage should be upright & below the level of tube insertion

d) Chest tube attached to top of client’s bed with adhesive tapes

• Ensure dressing is intact

• To assess the air leaks

• Chest tubes are only clamped under specific circumstances pre physician order

• To be quickly empty , If there is accidental disconnection of drainage tubing

• Positions :

• Semi-fowler’s position to evacuate

• High-fowler’s position to drain fluid

• Perform hand washing

• Evaluate for :

• Chest tube dressing

• Kinks & clots

• Drainage position

• Pain

• Water seal system

PULSE OXIMETRY

INTRODUCTION

• Pulse oximetry offers a non-invasive means of estimating the arterial oxygen saturation

• The pulse oximeter uses infrared light to determine the percentage of hemoglobin that is oxygen saturated

• Oxygen saturation should always be above 95%.

GENERAL POINTERS TO THE MANAGEMENT OF HYPOXAEMIA

• Oxyhaemoglobin saturation Management :

• 90-95% : Measure regularly and especially at night. Where value is unexpected, check signal quality and probe.

• 80-90% : As above, continuous monitoring and give oxygen until saturations above 90%.

• <80% : As above and consider ventilatory support.

USING AN OXIMETER

• Resting readings should be taken for at least five minutes.

• Poor perfusion (due to cold or hypotension) is the main cause of an inadequate pulse wave.

• If a finger probe is used, the hand should be rested on the chest at the level of the heart

• Checking that the displayed heart rate correlates to a manually checked heart rate (within 5 beats per minute) .

• Appropriately sized probes should be used for children and infants.

PURPOSES

• Monitor arterial oxygen saturation non-invasively

• Make an early detection of early hypoxemia

• Assess tolerance to lessen the oxygen therapy

Thank you…