PROCEDURE
FOR CLOSED CHEST DRAINAGE SYSTEM PURPOSE: To assure the
standardization of closed chest drainage system setup and management. EQUIPMENT: Closed chest drainage system Suction tubing to connect drain to
suction source (If ordered) Suction canister (If ordered) NURSING ACTION: PROCEDURE STEPS: 1. Open package and open
sterile wrap. 2. Swing out floor stand and
set drain upright on floor stand. 3. If present, slide tube
clamp to where the tubing enters the drain. 4. Remove ampoule of sterile
water from the back of the drain, twist off the top, and add water to the
water seal chamber through the suction port ( located on the top of the drain,
in front of the carry handle). 5. Fill water chamber to 2cm
fill line. 6. Connect chest drain to
patient, maintaining sterility of the connector. 7. Connect chest drain to
suction source by attaching suction tubing to the suction port on top of the
drain. 8. Adjust suction regulator
on drain to desired level by turning dial located on the side of the chest
drain. 9. Turn suction source on ;
Increase source level to -80 mmHg or higher. 10. Check monitor bellows to
be sure that bellows have expanded beyond the triangular indicator. KEY POINT : When suction levels are
decreased on a dry suction chest drain, the manual high negativity vent must
be depressed immediately after the adjustments are made to vent excess
negativity in the system resulting from the original higher suction
setting. If this is not done, the
patient and system will be subjected to higher negativity than that indicated
by the suction regulator. The water
level in the water seal will rise to reflect this higher negativity to remind
the operator to depress the negativity vent.
(The vent is used only when the patient is connected to source
suction). KEY POINT : Bubbling
indicates air leak is present.
Tidalling reflects pressure changes in the chest. REFERENCES: Wiegand, D.J., Carlson, K.K (2005). AACN
Procedure Manual for Critical Care, (Fifth Edition) Saunders. RESOURCE PERSON(S): Celestina D. Bryson RN, MSN, CCRN, CCNS,
MBA, APN |
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