JP Drain Basics
What is the primary purpose of a JP drain?
To remove fluid from a sugical site and reduce risk of infection or hematoma
What is a chest tube
A drainage system that uses gravity or suction to remove air, blood, or fluid from the pleural space.
What is the purpose of a PleurX drain
ongoing drainage of pleural fluid at home or inpatient.
You notice the chest tube drainage sitting next to the patient on the bed.
Place drainage system below the level of the chest to prevent backflow and assess the patient.
Once you empty a drain how do you re-establish suction?
By compressing the bulb and closing the plug while compressed
What does intermittent bubbling in water seal chamber indicate?
Air leaving the pleural space (expected early after insertion).
The drainage bottle is connected but no fluid is flowing. What should you do?
check for kinks, clamps or valve occlusions. Notify provider.
A JP drain is found fully expanded during your assessment.
Empty the drain, recompress the bulb and measure output
How often do you empty a JP drain and document?
Every 8hrs or as needed (2/3rds full)
What does continous bubbling in the water seal chamber indicate?
An air leak
While draining the patient complains of chest discomfort and coughing. What should you do?
Slow or stop the drainage and reassess patient.
The JP drain had no output, what do you document?
Document "0" output so provider knows it was "0" vs not documented.
What type of drainage is expected from JP drain early post op?
Serosanguinous drainage
What should you do if a chest tube becomes disconnected?
Place the tube end in sterile water to re-establish a temporary water seal.
You notice redness and warmth around the insertion site. What do you do
Assess site, monitor for signs of infection, notify provider and document.
You enter the room and the chest tube water seal is continously bubbling
Assess for air leak by checking the connections and tubing and reinforce dressing if needed. If unresolved notify provider.
A JP drain will not remain compressed. What is likely the cause and what do you do?
An air leak, improperly closed plug, tubing connection issue. Assess tubing and contact provider.
Where should the chest drainage system be positioned in relation to the patient?
Below the level of the chest
During drainage, more than 1000ml of fluid has been removed and the patient becomes dizzy. What do you do?
Straighten or remove the kink to restore drainage, assess breath sounds and vitals, notify provider.