CHEST TUBES
WHAT IS A CHEST TUBE?
sterile drainage system to remove air/fluid/blood from pleural space
ALWAYS HAVE XRAY PERFORMED TO ENSURE PROPER PLACEMENT
WHAT ARE THE 5 RIGHTS OF DELEGATION?
1. Right task
2. Right circumstance
3. Right person
4. Right communication/direction
5. Right supervision
WHY DO WE NEED A CHEST TUBE?
pleural effusion, pneumothorax, hemothorax, post op cardiac/lung surgery
Beneficence:
TO DO GOOD
TIDALING IS _____?
NORMAL
Nonmaleficence
TO DO NO HARM
CONTACT PRECAUTIONS
Diarrhea: C DIFF, rotavirus,
diarrhea, E Coli
Other: conjunctivitis, salmonella
Respiratory infections: RSV,
adenovirus, parainfluenza
Multi drug resistant: MRSA, VRE
Skin and wound infections
EXCESSIVE/CONTINUING BUBBLING MEANS?
AIR LEAK
Autonomy:
let patient make decisions for themselves
DROPLET PRECAUTIONS
Sepsis, streptococcal pharyngitis
Pneumonia, pertussis
Influenza A + B
Diphtheria
Epiglottitis
Rubella
Mumps,meningitis, meningeal pneumonia
Adenovirus
Neisseria Meningitis
Wet/Dry Suction Control Chamber
VIGOROUS BUBBLING?
SUCTION TO HIGH
JUSTICE
FAIR
DO YOU CLAMP A CHEST TUBE?
NO!!
VERACITY
TRUTH
WHAT DOES "RACE" STAND FOR?
ALARM
CONFINE
EXTINGUISH
WHERE SHOULD THE DRAIN BE?
FIDELITY
loyalty, fulfilling commitments, meeting
expected responsibilities
WHAT DOES "PASS" STAND FOR?
PULL THE PIN
AIM AT BASE OF FIRE.
SQUEEZE HANDLE
SWEEP SIDE TO SIDE
If the chest tube is removed from patient by accident?
ADD 3 SIDED DRESSING
ASSAULT
THREAT
AIRBORNE PRECAUTIONS
Shingles (disseminated)
Measles
TB (active)
Varicella (uncrusted)
BATTERY
physical contact without permission
AIRBOURNE PRECAUTIONS PPE/EDUCATION
PPE: N 95 MASK plus standard precautions and other PPE as needed
- Negative pressure room
- Keep door closed at all times
- If patient leaves room: surgical mask