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When to Use or Not Use By Don Hudson D.O.

CHEST TUBES. When to Use or Not Use 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, hemopneumothorax and empyema (pus) useful in fluid collection

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When to Use or Not Use By Don Hudson D.O.

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  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 TubeInsertion • 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 don’t know if you are coming or going but for now we’re done. Thank you for your attention.

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