What's Up
Pieces & Parts
Do's and Don't
Ooooops!
100
What do you call it when air leaks into the space between the lung and chest wall resulting in lung collapse?
Pneumothorax
100
How many chambers are in a chest tube collection device?
3 Chambers
100
Your patient wants to go for a walk. Is this a do or a don't?
Do
100
While getting your patient back to bed, you kick over the collection chamber! Oooops! What do you do?
Assess patient, set collection device upright, tilt to allow drainage to return into correct chamber, notify provider.
200
You view the x-ray with the doctor and note the right lung field is mostly whited out. Why would the doctor ask for a chest tube set-up?
Presence of infection, empyema, hemothorax, or chylothorax
200
Which side of the chest tube is inserted into the patient?
B
200
Your patient is being transported in a wheelchair and you hang the chest tube collection device on the back of the wheelchair. Is this a do or a don't?
Don't
200
You have kicked over the collection device, set it upright, tilted to allow drainage to return to correct chamber, and notified the provider. However, now you have serous and sanguineous fluid mixed in the drainage chamber. Ooops! What do you do?
Change the system, clamping the tube momentarily.
300
You view the x-ray with the doctor and note the left lung field is dark. Why would the doctor ask for a chest tube set-up and at what intercostal space would the doctor place the chest tube?
Presence of air and anterior placement, mid axillary line, 4th or 5th intercostal space.
300
What are the 3 chambers of the chest tube collection device?
Drainage Chamber
Water Seal Chamber
Suction Control Chamber
300
Your patient's chest tube becomes dislodged and you cover the site with a washcloth and hold pressure. Is this a do or a don't?
Don't
300
You notice your patient using the incentive spirometer. With every inspiration the air leak monitor bubbles rapidly. Oooops! What do you do?
Systematically search for the air leak.
400
After a right lung thoracentesis, the patient complains of severe shortness of breath, chest tightness, and feeling lightheaded. Right lung sounds are absent. Why would the doctor call for emergency chest tube placement?
Iatrogenic Pneumothorax
400
How much sterile water must be in the water seal chamber?
2cm (45ml)
400
The doctor has pulled the chest tube. You cover the site with Xeroform and gauze taped on 4 sides. Is this a do or a don't?
Do
400
Your confused patient has disconnected the chest tube from the collection device. Oooops! What do you do?
Place the end of the chest tube in 1 inch of sterile water, assess patient for tension pneumothorax, and notify the provider.