Anatomy of the Atrium Oasis Chest Tube
The "A" on the Chest Drain (Atrium Oasis) has this functionality.
What is the Dry Suction Regulator.
This will be set per the orders and is adjusted by the rotary dry suction dial located at the side.
Tidaling
What is the rise and fall of the float ball within the Air Leak Monitor. The volume will lower with expiration, and rise with inspiration.
Tidaling is a normal and expected finding.
This is what you should do if the chest tube becomes dislodged.
What is cover the site with a sterile dressing and tape it on three sides to allow air to escape. Stay with the patient, notify the provider, and monitor for signs and symptoms of tension pneumothorax. Anticipate reinsertion (have someone bring a chest tube kit).
Air in pleural space
What is pneumothorax?
The "D" on the Atrium Oasis chest drain is this portion of the drain.
What is the collection chamber.
The chamber should be marked with a pen or sharpie at the end of each shift to determine total output.
Continuous or intermittent bubbling going from right to left.
What is an air leak?
Air leak can be measured from low volume of 1 to larger air leak volume of 5.
Bubbling from right to left in the air leak monitor must be present to confirm active air leak.
What you do when suspecting an air leak.
What is observe for continuous or intermittent right to left bubbling in the air leak chamber. Check all connections and tubing for issues. You may very briefly clamp the tube to verify if the air leak is from the system/tube or from the patient.
Excess fluid in pleural space
What is pleural effusion
The "C" on the Atrium Oasis chest drain has this function.
What is the Air Leak Monitor.
Constant bubbling or frequent intermittent bubbling is a sign of an air leak.
Type of chest tube set up that is not hooked up to active suction.
What is a Water Seal?
This is also called 'gravity drainage'. The patient has a chest tube in place but is not hooked up to suction.
You would do this if the suction bellows of a dry suction drainage unit does not reach appropriate range (delta mark).
What is verify proper level of suction is set on suction chamber (at least -20mm, but usually greater), verify system is appropriately attached to wall suction, and wall suction is set to at least -80mm Hg.
If the suction bellow is still not at the delta mark, slowly increase the level of wall suction.
Blood in pleural space
What is Hemothorax
The "B" on the Atrium Oasis chest drain has this function.
What is the water seal chamber.
The water seal chamber should always be filled to no more or less than the 2cm fill line.
Crepitus
What is palpable, audible popping, crackling, or crunching sensation that can occur when air is pushed through the soft tissue of the chest?
What is momentarily clamp the tube close to insertion site (monitor very closely for s/s of tension pneumothorax) OR alternatively, submerge distal end of tube in bottle of sterile water to create a temporary water seal.
Replace the drainage unit immediately and unclamp tube.
Collection of pus in the pleural cavity.
What is empyema?
The "E" on the Atrium Oasis chest drain has this function.
What is the suction monitor bellows.
With adequate suction, the bellow will be pulled out to the delta mark. If the bellows does not reach the delta mark, slowly increase suction.
Milking, stripping, or clamping.
What are variations of temporarily occluding the drainage system.
Milking, stripping, or clamping the tubing is contraindicated due to the drastic changes in intrathoracic pressure that can result.
You would do this if the drainage unit is knocked over.
What is place unit upright immediately and check fluid level in the water seal for proper volume. If drainage has spilled from one chamber to another, gently tip unit to the right to drain fluid back to correct column.
If significant drainage has entered water seal, consider replacing unit.
A life-threatening emergency in which air cannot escape the pleural space, putting immense pressure on the lungs, heart, and blood vessels.
What is tension pneumothorax?