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CCEMT-P SM Aug-131

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By Don Hudson D.O. Chest Tubes Indications and purpose drainage of fluid and air from pleural space or mediastinum used to treat pneumothorax, hemothorax ... – PowerPoint PPT presentation

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Title: CCEMT-P SM Aug-131


1
CHEST TUBES
  • When to Use or Not Use
  • By Don Hudson D.O.

2
Chest Tubes
  • Indications and purpose
  • drainage of fluid and air from pleural space or
    mediastinum
  • used to treat pneumothorax, hemothorax,
    hemopneumothorax and empyema (pus)
  • useful in fluid collection
  • helpful in respiratory assistance

3
Positioning
4
Chest Tube Insertion
  • Site
  • Procedure

. Complications
5
Assessment of Chest Tubes
  • Respiratory effort and status
  • Suction versus water seal method
  • Tube placement
  • intact dressing
  • sutures
  • signs of infection
  • loss of tube integrity

6
X-Rays
7
Now What ?
X-Rays
8
Assessment of Chest Tubes
  • Adequate drainage
  • quality and amount
  • color changes, blood, pus
  • Adequate suction
  • maintain dependent loop
  • milking chest tube
  • placing on water seal
  • adjustments

9
Do these Work ?
10
How Good are the Small Tubes ?
  • When can you use a Himlick valve ?
  • Why would you use it ?
  • What can you reasonably expect it to do ?

11
Complications of Chest Tubes
  • Recurrent pneumothoracies
  • Accidental removal
  • immediately apply occlusive dressing to site
  • do not reinsert tube
  • monitor vital signs closely
  • ventilate prn
  • consider diversion to appropriate facility

12
Complications of Chest Tubes
  • Broken collection chamber
  • loss of suction
  • can cause open pneumothorax

. USE IN AIRCRAFT
. UNIVERSAL PRECAUTIONS
13
Chest Tubes
ATER INSERTION NOW WHAT ? WHO DO YOU ANSWER TO
? WHAT TRAINING IS APPROPRIATE ?
Chest tubes scare everyone
Conclusion
14
  • Some times you really dont know if you are
    coming or going but for now were done. Thank
    you for your attention.
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