chest tube thoracostomy.pptx

8/14/2019 CHEST TUBE THORACOSTOMY.pptx

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THORACOS

TOMYJill Catherine Cabana

Anna Patricia Santua

BSN4


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DEFINITION is a surgical opening in the chest wall

and inserting a thoracostomy tube

(chest catheter) is inserted into the

chest wall above the area of the secondor third rib. A local anesthetic (xylocaine

1% or 2%) is administered and an

incision is then made into the pleural

space of the chest wall. The tube isinserted, positioned, and clamped, and

silk sutures are use to secure the chest

tube in place.


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PURPOSESPurposes:

-Remove excess air, blood, or fluid from the pleural cavity,

-Reduce the size of the pleural space, and restore

negative intrapleural pressure to promote lungexpansion.

-Remove tumors of the lung, bronchus or chest wall

-Repair or reverse structures contained in the thorax such

as open heart surgery or repair of a thoracic aneurysm.-Repair trauma to the chest or chest wall, such as

penetrating chest wounds or crushing chest injuries.

-Sample a lesion for biopsy.


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INDICATIONS Surgery

Traumatic chest injuries

Pneumothorax Hemothorax

Pleural effusion (build up of fluid

between the pleura)

Infection (empyema)


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DRAINAGE-known as the water seal drainage.

-use to restore the negative pressure that has been lost

inside the pleural space owing to pneumothorax, and to

prevent additional air and fluid from entering the pleural

cavity. The chest tube leads from the chest via plastic or

rubber tubing to a glass container in which the end of the

tube is attached to a glass rod submerged in water. An air

vent allows the escape of air, which bubbles up through the

water. This constitutes the water seal which prevents airfrom traveling up to the tube to the pleural space in which

negative pressure must develop to re-expand lung.


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system (Valve)

It provides water-seal gravity drainage. The gravitysystem allows the flow of air or water into the bottle when

the pressure in the pleural space is sufficient to displace

the water in the glass rod. The long glass rod is

submerged about 2 cm below the water surface; anintrapleural pressure greater than 2 cm in the pleural

space will be required to displace it.

Since the gravity water-seal drainage bottle is covered

with a stopper, the short glass rod simply serves to allowthe escape of air from the bottle. If this short glass rod

becomes occluded, air pressure could build up within the

bottle. This increase pressure pushes the water in the

bottle up the long glass tube toward the chest, risking

back flow of fluid into the chest.


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seal drainage system

(Valve+ Drainage) It involves the addition of a suction source and a suction-

control bottle. It is added if gravity is not sufficient to clear

the air or fluid from the chest. The suction-control bottle

allows the entrance of air which bubbles through the column

of water in the glass rod, reducing the amount of negativepressure from the suction source. This is sometimes called

a suction-breaking bottle.

When the force of suction exceeds that required to displace

the water inside the glass rod, from the water level down tothe end of the glass rod, room air will be drawn into the

system to reduce the negative pressure applied to the chest.

Failure of the breaker bottle to bubble means that the

desired amount of suction has not been reached.


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Water Seal

(Valve)

Drainage


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-system 3 Bottles=Valve + Drainage + Pull

It involves the addition of a separate collection

bottle so that the drainage may be separatecollection bottle so that drainage may be

measured and inspected as it comes from the

chest.


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Pleur-evac It is a commercially available product incorporating all

the features all ready discussed. It is a single light

weight unit which indicates the amount of air bubbling

through the suction chamber from the atmosphere. It

calibrates the exact amount of negative pressure in thepleural space and has a client leak air flow meter to

indicate the amount of air coming from the individual


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Responsibilities ASSESSMENT

Patency/functioning of system (kinks, clamps,atrium, suction, etc)

Dressings

Quantity and quality of drainage

Dependency of collection system

Coiled tubing, not hanging tubing

Pain control

Respiratory status and Vital signs


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Responsibilities ASSESSMENT

Note specific orders regarding:

Suction versus water seal

Amount of acceptable drainage

I & O

X-rays

Administer pain medications regularly

Patient should change positions frequently

(promotes drainage, prevents complications)


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THANKYOU! :D

chest tube thoracostomy.pptx

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