1. When to Use or Not Use By Don Hudson D.O.
December 17
CHEST TUBES
When to Use or Not Use
By Don Hudson D.O.
Breathing Management

2. Chest Tubes Indications and purpose
December 17
Chest Tubes
Indications and purpose
drainage of fluid and air from pleural space or mediastinum
used to treat pneumothorax, hemothorax, hemopneumothorax and empyema (pus)
useful in fluid collection
helpful in respiratory assistance
Breathing Management

3. Positioning
Breathing Management

4. . Complications Chest Tube Insertion Site Procedure
Breathing Management

5. Assessment of Chest Tubes
Respiratory effort and status
Suction versus water seal method
Tube placement
intact dressing
sutures
signs of infection
loss of tube integrity
Breathing Management

6. X-Rays
Breathing Management

7. Now What ?
X-Rays
Breathing Management

8. Assessment of Chest Tubes
Adequate drainage
quality and amount
color changes, blood, pus
Adequate suction
maintain “dependent loop”
milking chest tube
placing on water seal
adjustments
Breathing Management

9. Do these Work ?
Breathing Management

10. How Good are the Small Tubes ?
When can you use a Himlick valve ?
Why would you use it ?
What can you reasonably expect it to do ?
Breathing Management

11. Complications of Chest Tubes
Recurrent pneumothoracies
Accidental removal
immediately apply occlusive dressing to site
do not reinsert tube
monitor vital signs closely
ventilate prn
consider diversion to appropriate facility
Breathing Management

12. Complications of Chest Tubes
Broken collection chamber
loss of suction
can cause open pneumothorax
. USE IN AIRCRAFT
. UNIVERSAL PRECAUTIONS
Breathing Management

13. Chest tubes scare everyone
ATER INSERTION NOW WHAT ?
WHO DO YOU ANSWER TO ?
WHAT TRAINING IS APPROPRIATE ?
Chest tubes scare everyone
Conclusion
Breathing Management

14. Some times you really don’t know if you are coming or going but for now we’re done. Thank you for your attention.
Breathing Management