Upload
hady920
View
266
Download
13
Tags:
Embed Size (px)
DESCRIPTION
Chest tubes & Water seal Drainage.ppt
Citation preview
Concepts on Concepts on OxygenationOxygenation
Chest tubes & Water seal Drainage
Indications for Chest tube drainage
To evacuate air or fluid from pleural space Pneumothorax > 20 % Hemothorax > 500cc Pneumohemothorax Pleural Effusion Fluid collections Mechanically ventilated patients with any size
pneumothorax or hemothorax
Indications for Chest tube Drainage
Respiratory distress or ventilator dependence that does not permit thoracentesis
Monitor ongoing air leak or blood loss
Contraindications
Coagulopathy or platelet dysfunction warrants caution
Known or suspected mesothelioma Pure tuberculosis effusion
Types & Purposes of Chest tubes
1. Pleural Tubes> the insertion
of pleural tube permits removal of the air or bloody fluid & allows for reexpansion of the lung and restoration of the normal negative pressure in the pleural space .
Types & Purposes of Chest Tubes cont’d.
2. Mediastinal tubes
> are placed to en -
sure that fluid does
not accumulate &
put pressure on the
heart but instead
drains to facilitate
healing
Chest Tube Size
French sizing refers to circumference in millimeters
Pure Pneumothorax : French 20 – 24 Fluid : French 28 tubes are recommended French 32 or larger tubes tend to cause too
much discomfort unless a rib resection is performed
Principles of Chest Principles of Chest DrainageDrainage
Principles Involved
Gravity positive pressure Suction Water – seal principle
TYPES OF CHEST TYPES OF CHEST TUBE DRAINAGE TUBE DRAINAGE
SYSTEMSYSTEM
1. SINGLE – BOTTLE WATER SEAL SYSTEM
The end of thedrainage tube from thepatient’s chest is covered by alayer of water , which permitsdrainage of air & fluid from the pleural space , but does not allow air to move back into the chest . Functionally , drainagedepends on gravity , on the mechanism of resopiration , & ifdesired , on suction by addition of controlled vacuum
2. TWO – BOTTLE WATER SEAL SYSTEM
consists of the same water – seal chamber , plus a fluid – collection bottle
Drainage is similar to that of a single unit , except that when pleural fluid drains , the underwater – seal system
is not affected by the volume of the drainage
Effective drainage depends on gravity or on the amount of suction added to the system
3. THREE- BOTTLE WATER SEAL SYSTEM There’s an addition of a 3rd
bottle to control the amount of suction applied
The amount of suction is determined by the depth to which the tip of the venting glass tube is submerged in the water
Drainage depends on the gravity or the amount of suction applied , which is controlled by the manometer
bottle The mechanical suction motor /
wall suction creates & maintains a negative pressure throughout the entire closed drainage system
4. PLEUR – EVAC WATER SEAL SYSTEM
Is a three- chambered system that utilizes the same basic principles as the classic three-bottle system