ppt课件-chesttubesammarzahreddinern,bsn,clinicalinstructor.pptVIP

CHEST TUBES Objectives: Discuss the anatomy of the chest and the mechanism of respirations Discuss the indications for a chest tube Discuss the structure and function of the chest bottle (drainage system) Troubleshoot the problems with/maintain chest tubes and chest tube bottles Inspiration: Decreased lung volume Ribs move inwards and downwards Diaphragm moves upwards Pleura: THE PLEURAL SPACE HAS ALWAYS A NEGATIVE PRESSURE. OTHERWISE, THE LUNGS WILL COLLAPSE Pleural Pressure: The degree of negativity changes throughout the respiratory cycle Intrapleural pressure normally ranges from –(4) to –(10) cm of water Inspiration pressure drops to –(10) cm water Expiration pressure rises up to –(4) cm water It is the pressure variance that allows the air to move in and out easily Definition of the chest drainage Is the insertion of a tube into the pleural and/or mediastenal space and a physician order required for the type of evacuation force: a-normally 20cm for adult b-10-15cm for pediatric The drainage must be kept always lower than the patient to prevent backflow of fluid into the pleural or mediastinal space. Indications of a Chest Tube: Pneumothorax Hemothorax Hemopneumothorax Pleural Effusion Empyema Drainage Chest tube location For evacuation of air: 2,3,4 intercostals space are commonly used sites. To drain fluid : 5,6 intercostals space are commonly used sites. CHEST DRAINAGE SYSTEM UN DEUX TROIS Fluid Collection Chamber: Collects fluid as it drains from the pleural space or mediastinal space Water Seal Chamber: Acts as a one way valve, allowing air to escape from the patient and never return back. Always 2 cm of water. Suction Control Chamber: Controls the amount of suction applied directly to the patient. It improves the rate and flow of drainage. Subcutaneous Emphysema: When the lungs or the air passages are injured, air may enter the tissue planes and pass for some distance under the skin. The