chest drains

Question	Answer
chest injury	blunt, crush, penetrating, inhalation, aspiration, compression, distraction
major force that lead to injury - compression	results in destruction of vascular components, haemorrhage, oedema, and impairment of function
major force within chest that leads to injury distraction	results in shearing force which destroys integrity of intrathoracic viscera
chest drains- pulmonary pressure cariation	inhalation - diaphragm presses the abdo organs down and forward exhalation - diaphragm rises and recoil to resting position
ventilation perfusion ratio	v - ventilation air that reaches alveoli q - perfustion - blood that reaches alveoli via the capillaries defined as - amount of air reaching the alveoli per minute to amount of blood reaching alveoli per minutes these 2 values show blood oxygen and carbon dioxide concentrations
indications for a chest drain	persistent pneumothorax, tension, traumatic, any patient with pneumothorax requiring positive pressure ventilation emphysema, hamorrhagic collection
tension pneumothoraz	tracheal shift, compressed lungs, compressed vessels, pleural space filled with air, compressed heart
traumatic pneumothorax	traumatic rupture in chest wall, inhalation where air enters injured side causing collapsed lungs
chylothorax	type of pleural effuction resulting from lymphativ fluid accumulating in pleural cavity
insertion of chest drain	entry into the thoracic cavity - fogging of tube, resp swing, bubbling, coughing x-ray confirmation - ensure lung expands, screen for complications
complication of insertion	traumativ perforation of lung trauma to intercostal neurovascular bundle re-expansicon of pulmonary oedema infection at site or pleural space
nursing management	safety, suction, dressing, tubing, bottle, unit, daily assessment, documentation
nursing management -daily assessment	volume, nature of drainage, regular chest x-rays, air leaks, dressing, pain, positioning
complications	signs of pneumothorax - decrease sao2, increased wob, breth sounds decreased, hypotension, decreased chest movement notify mo, urgent CXR, -bleeding at drain site - apply pressure, place non-occlusive dressing over site -infection notify mo, swab wound site, consider blood cultures
accidental disconnection	clamp tubing, clean ends of drain, reconnect, ensure unclamped once solved
accidental drain removal	apply pressure to site, steri strips, place occlusive dressing over top check vital, mo
nursing documentation	each shift -drainage amount, fbc, swining, bubbling, appearance, tube placement, patency, pain
removal	mo-written order absense of an air leak drainage diminishes no resp compromise CXR - lung re-expansion ensure pt fasted, adequate pain control, sedation, distraction therapy
post removal care	attend to pt comfort, sedation, CXR performed, clinical status best indicator monitor vitals, document removal, remove sutures after 5 days post removal, dressing insitu for 24 hours post removal

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	Created by Elizabeth Then over 6 years ago