What is a Chest Tube?
A chest tube, also known as a thoracic catheter, is a flexible plastic tube that is inserted through the chest wall and into the pleural space. The primary purpose is to remove air, fluid, or pus from the intrathoracic space to help the lungs expand fully.
Indications for Chest Tube Insertion
Chest tubes are typically used in conditions such as pneumothorax, hemothorax, pleural effusion, and empyema. They can also be used post-operatively after thoracic surgery to manage air and fluid accumulation.
Procedure for Chest Tube Insertion
The insertion of a chest tube is generally performed by a physician or a trained advanced practice nurse. The procedure involves local anesthesia and is often done at the bedside or in an emergency room setting. The insertion site is usually between the fourth and fifth ribs.
Nursing Care of Patients with Chest Tubes
Monitoring and Assessment: Nurses must regularly monitor the patient for signs of respiratory distress, changes in breath sounds, and the amount and color of drainage. It is also important to check the insertion site for signs of infection or subcutaneous emphysema. Maintaining the Chest Tube System: The chest tube must be kept free from kinks and occlusions. Nurses should ensure that the tubing is secured and that the drainage system remains below the patient’s chest level to facilitate proper drainage.
Pain Management: Chest tube insertion can be painful, and effective pain management is crucial. Administering prescribed analgesics and employing non-pharmacological pain relief methods can help the patient manage discomfort.
Complications and Troubleshooting
Complications such as infection, bleeding, and accidental dislodgement of the chest tube can occur. Nurses should be vigilant and prepared to intervene if necessary. Regular assessment and prompt reporting of any abnormalities to the healthcare team are essential.
Patient Education
Educating patients and their families about the purpose of the chest tube, what to expect during their care, and signs of potential complications is paramount. Providing instructions on activity restrictions and how to care for the insertion site at home can help in the recovery process.
Removal of Chest Tube
The chest tube is usually removed when the lung has fully re-expanded, and there is minimal drainage. Removal is performed by a healthcare provider, and the patient should be monitored for any signs of respiratory distress or complications post-removal.
Conclusion
The management of patients with chest tubes involves comprehensive care and continuous monitoring. Nurses play a crucial role in ensuring the effectiveness of the chest tube, preventing complications, and providing holistic care to support patient recovery.
