Chest Tube Basics
Drain air, blood, or fluid that may accumulate in the pleural space after surgery, helping prevent lung collapse and promoting proper lung expansion.
What is the primary purpose of a chest tube in a patient post-anterior spinal fusion?
•Patient Respiratory assessment
•Chest tube site assessment
•Drainage set up (equipment)
What are the assessments to Complete q Shift?
•Output >5mL/kg in 1 hour
•Output >3mL/kg consistently for 3 hours
What is notify the MD?
Between the ribs, in the mid-axillary or anterior axillary line, to allow drainage from the pleural space.
Where is a chest tube typically inserted in pediatric patients after anterior spinal fusion?
Sudden cessation of drainage, bubbling in the water seal chamber (indicating an air leak), and patient symptoms such as increased respiratory distress or decreased oxygen saturation levels.
What signs might indicate that a chest tube is no longer functioning properly in a post-operative patient?
Bradycardia
What is a late sign the patient with a chest tube is decompensating?
Infection, tube displacement, pneumothorax (air in the pleural space), hemothorax (blood in the pleural space), and injury to nearby structures such as the lung, diaphragm, or heart.
What are the potential complications of a chest tube in a pediatric patient following anterior spinal fusion surgery?
High or semi fowler's (30-45 degrees).
What is patient position to facilitate drainage?
•2 drain clamps (per chest tube)
•2 suction outlets: one for chest tube, one for airway
What are the Bedside Emergency Equipment supplies?
Often -20 cmH2O
What is ensure suction is at correct measurement according to MD prescription?
Positive pressure can build up and cause the patient to have difficulty breathing.
What is caused by an air leak?
Ask patient to Cough & Exhale.
Cover site with sterile dressing taping only 3 sides allows air to escape from 4th side. (Occlusive dressing)
What is the intervention for a dislodged chest tube?