Chest Tube Simple Nursing

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The management of disorders like pneumothorax, pleural effusion, and postoperative drainage frequently involves the use of chest tubes, which are a crucial part of medical care in a variety of clinical settings. Understanding the foundations of chest tube care is critical for nurses since they play a crucial role in the care and management of patients with chest tubes. We will discuss the fundamentals of chest tubes in this post and offer a straightforward nursing guidance to ensure secure and efficient chest tube administration.


I. Understanding Chest Tubes


Nurses must first comprehend the purpose of chest tubes in order to handle them effectively.


1. What are Chest Tubes?

Chest tubes, often referred to as thoracostomy tubes or chest drains, are flexible, hollow tubes that are introduced into the pleural space to drain out blood, fluids, or other waste products. They support the restoration of negative intrapleural pressure, enabling normal lung expansion and operation.


(i) Indications for Chest Tubes

Chest tubes are utilized in various medical situations, including:


a. Pneumothorax: To evacuate air that accumulates in the pleural cavity, causing lung collapse.

b. Pleural Effusion: to remove extra fluid from the pleural area, such as blood, pus, or serous fluid.

c. Postoperative Chest Drainage: after thoracic procedures to avoid fluid or air buildup.


II. Nursing Considerations for Chest Tube Insertion


Chest tube insertion is a crucial surgery that needs careful nursing attention.


1. Pre-Procedure Preparation


a. Gather necessary equipment: A chest tube drainage system, sterile gloves, drapes, and a kit for inserting a chest tube should all be present.

b. Informed Consent: Verify that the patient has consented to the procedure in full knowledge.

c. Positioning: Help the patient get into a comfortable position for the surgery, usually semi-Fowler's or sitting up straight.

d. Infection Control: To avoid infections, use strict aseptic practises throughout the procedure.


2. Monitoring and Assessment


a. Vital Signs: Before, during, and after the placement of the chest tube, keep an eye on the patient's vital signs.

b. Respiratory Assessment: The patient's respiratory condition should be evaluated, including oxygen saturation and breath sounds.

c. Pain Management: Administer prescribed pain relief medication as necessary to ensure patient comfort.


III. Chest Tube Insertion Procedure


Precision and close observation are necessary for the chest tube's actual implantation.


1. Sterile Field


a. Create a sterile field around the insertion site using sterile drapes.

b. Wear sterile gloves and practise good hand hygiene during the operation.


2. Anesthesia


a. To numb the area and reduce the patient's discomfort, administer local anaesthesia at the place of insertion.


3. Insertion


a. The chest tube will be inserted into the pleural space after the healthcare provider makes an incision at the chosen insertion point, which is often in the mid-axillary line.

b. Secure the tube in place with sutures and connect it to the drainage system.

c. Dress the wound and ensure airtight closure.


IV. Post-Insertion Care


After inserting the chest tube, nursing attention is required to monitor and handle any potential problems.


1. Chest Tube Drainage System


a. A closed drainage system with a collecting chamber, water seal chamber, and suction control chamber should be connected to the chest tube.

b. Ensure that the system remains below the level of the patient's chest to facilitate gravity drainage.


2. Respiratory Assessment


a. Evaluate the patient's respiratory state on a constant basis, paying attention to breath sounds, chest movement, and indications of respiratory distress.

b. Monitor oxygen saturation and administer supplemental oxygen if required.


3. Chest Tube Drainage


a. Check the chest tube drainage system to make sure it is operating properly.

b. Record drainage output, color, and consistency regularly.

c. Inform the healthcare professional of any abrupt increases in drainage output or changes in colour.


V. Complications and Troubleshooting


Chest tubes may cause difficulties, therefore nurses should be aware of them and be prepared to handle them.


1. Air Leaks


a. Keep an eye out for persistent bubbling in the water seal chamber as this could point to an air leak.

b. Ensure that all connections are secure and assess the insertion site for leaks.


2. Tension Pneumothorax


a. A tension pneumothorax may be indicated by indicators of deteriorating respiratory difficulty, tracheal deviation, and hemodynamic instability.

b. Promptly inform the healthcare provider for immediate intervention.


3. Infection


a. Keep an eye out for infection symptoms like redness, swelling, warmth, or purulent discharge at the insertion site.

b. Maintain meticulous wound care to prevent infection.


VI. Patient Education


To ensure that the patient understands and cooperates with the management of their chest tube, proper patient education is essential.


1. Pain Management


a. The patient should be informed of the significance of pain control and encouraged to express any discomfort right away.

b. Ensure that the patient receives pain relief medication as prescribed.


2. Mobility


a. Tell the patient to avoid making any rapid movements that could cause the chest tube to come loose.

b. Encourage early ambulation to prevent complications like atelectasis.


3. Drainage System


a. Reassure the patient of the chest tube drainage system's functionality by explaining its role.

b. Encourage the patient to report any unusual changes in the system.


VII. Documentation


For the purpose of ensuring continuity of care and monitoring the patient's progress, accurate documentation is essential.


1. Record any pertinent data, including the day and time the chest tube was inserted, the amount of drainage produced, the patient's vital signs, and any complications or treatments.

2. Keep records of the patient's education and comprehension of chest tube treatment.




A vital nursing skill that calls for expertise, focus on detail, and compassion is managing chest tubes. Nurses may confidently provide safe and effective treatment to patients needing this crucial intervention by becoming familiar with the fundamentals of chest tubes. Remember that for patients with chest tubes, simplicity in nursing care is frequently the key to ensuring the greatest outcomes, making this manual a useful tool in your nursing practise.

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