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Chest Drain - fundamentals

Chest Drain - fundamentals. Pleural Aspiration –Tension Pneumothorax. 2 nd intercostal space midclavicular line Use venflon or central line catheter (avoid sharp needle’s) O2 Then arrange for chest drain.

kirsten-snow
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Chest Drain - fundamentals

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  1. Chest Drain - fundamentals

  2. Pleural Aspiration –Tension Pneumothorax • 2nd intercostal space midclavicular line • Use venflon or central line catheter (avoid sharp needle’s) • O2 • Then arrange for chest drain

  3. “There is no organ in the thoracic or abdominal cavity that has not been pierced by a chest drain.”

  4. Safety Precautions • Consent – Written & informed • Lignocaine test dose • Check & Ensure the side (right or left) of ICD • Clinical Examination • CXR • O2 must be connected • SpO2 Monitor

  5. Position-for Pleural aspiration/ Thoracocentesis ONLY

  6. Position - Triangle of safety

  7. Chest Drain Insertion Steps

  8. Chest Drain Insertion Steps…

  9. Underwater Seal Options

  10. Post ICD Care • Adequate pain control • Ambulate & Chest physiotherapy, O2, Nebulisation…… • NEVER Clamp the chest drain – if BPF is persistent –ICD clamping may create tension pneumothorax • Assess for air leak on asking to take deep breath or on coughing –confirm NO air leak • Chest x-ray • ICD column not moving ? • Lung is fully expanded • Blocked (less likely in 28/32 drain)

  11. When to Remove ICD • NO Air leak (BPF has closed) • Assess for air leak on asking to take deep breath or on coughing –confirm NO air leak • Lung Fully Expanded • Clinically • Chest x-ray • Drainage is less than 100ml/24hrs

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